Chesticle Festival

“Fuck,” Lucia muttered as we walked into the hospital. I followed her gaze to the opposite side of the lobby, where there hung a cross bearing a White Jesus. The place was called Mercy, so I guess I should’ve known it was a religious hospital, but I hadn’t thought about it. Technically I should’ve had my pre-op done there, but with the way things turned out, the day of my mastectomy was my first time there. Everything leading up to this day had been so convoluted, so unnecessarily difficult that a little religion thrown in at the end wasn’t even the worst of it. But Lucia, raised in a mostly-Catholic country by atheist parents, was more vehemently opposed to religion than I was. I squeezed her hand as we headed to reception. The White woman at the desk directed us to intake, where we sat in a small waiting area in front of a row of offices.

Two minutes later, we were called into the first office and greeted by a smiling White woman who had me sign a lot of paperwork. Here is the HIPAA consent, here is where you consent to CPR if anything should go wrong on the operating table, here is an indemnity waiver. She looked me up and down and hit a few keys. “I’m putting you down as Race 1, Ethnicity 2. Is there a religious affiliation you’d like me to register today?”

Lucia and I looked at each other. “Do you think that’s a good score?” I asked her.

She wasn’t amused. “What’s Race 1, Ethnicity 2?”

“Race 1 is White, Ethnicity 2 is non-Hispanic.” Of course. The nurse was putting labels with my information on all my paperwork. I don’t know what I’d expected her to say. It would be too much work to go through the “I’m-actually-Latinx” thing with this woman, so I didn’t.(1) I declined to list a religious affiliation—that, too, would’ve been complicated: I have Jewish heritage, was raised Christian, and don’t believe in God— and busied myself signing all the forms the woman thrust at me.

“Any allergies?”

“Kiwi and pineapple.”

“What happens when you have them?” “My lips swell and my mouth itches.”

“You want to keep an eye out for that. It can turn into a latex allergy later. Any allergies to medications? No? Okay.” When all the papers had been signed, we moved to the next office, where another White nurse inserted an IV and drew blood. It was thick and dark; the tube took forever to fill, prompting the nurse to say I was probably dehydrated. I stared at the floor as the nurse took my vitals. I was nearing twelve hours without food. I normally need to eat every four to five hours and am emotionally incontinent when my blood sugar is low. Lucia knew this, so she did the talking for me as much as possible.

A Black nurse named Debbie came in and handed me a cup for a urinalysis. She looked me up and down, looked at the surgery I was getting, and asked how she should refer to me. The welcome, tender question made me burst into tears. Debbie looked concerned. “It’s really fine,” Lucia said. “Just say Emerson, it’s easier.” (2) Debbie nodded and disappeared. I ducked into the bathroom to provide a sample and came back, swaying with dizziness, to my chair by Lucia.

We made our way through two more offices before I was asked to change into a hospital gown and given a bed. It was freezing, and after a short while of motionlessness, I couldn’t feel my toes. Every time a nurse came to take blood, they asked my name and birthdate, just to make sure I was the right person. They made me look at the tubes of blood to make sure they’d written the right thing on them. “There are so many more things we have to check for and match these days,” one nurse said to me. “It’s not just blood type and positive or negative anymore like you learned in school.” I like biology, and if I’d been in my right mind I’d have asked more questions, but I just nodded at her and asked for another blanket.

The only other nurse whose name I remember was the last one, who wheeled me into the holding room right before the surgery. The others had been calling her Annie, but her name tag read my deadname and she looked Latina. When she introduced herself, Lucia and I exchanged bemused smiles over the coincidence. “It’s a sign,” I said. She smiled without parting her lips and wore blue gloves. She took charge of my bed and we walked a few steps only to stop. “This is the place where people usually kiss—or hug,” she added quickly.

I was so bundled in blankets I couldn’t move. Lucia kissed my forehead, said, “See you on the other side,” and stepped back. Annie pushed me through double doors into the holding room, where it was even colder. I met the surgeon’s assistant, a young woman, maybe Filipina; she wore a mask but had kind eyes. Then the anesthesiologist came in, a tall White man with a loud voice. He asked if I was allergic to any medicines. “Not that I know of,” I said.

He looked at my chart. “This kiwi/pineapple allergy can turn into a latex allergy, you know.”

“I know.” My surgeon still hadn’t shown. The nurse assured me she was in the building. I wondered vaguely if she’d hit traffic. I was so cold and hungry my thinking felt slow, disjointed.

Finally Dr. V came in. She had her hair pulled back in a tight, impeccable ponytail and, having forgotten since our first appointment what she looked like, I was again struck by how beautiful she was. I’d chosen her because of her background. She grew up in India studying dance. She studied ballet and modern dance for twenty years and then decided to become a surgeon in the US. She had an artistic side and a scientific side. I could relate to that. And anyone who chooses two fields requiring precision and control has talent.

Once she came in, they quickly wheeled me into the operating room. It was smaller than I’d expected, and the lights were blinding. The assistant and anesthesiologist helped me move from the bed to the narrow table. “Center yourself on it. Then bring your arms up.” I did and was buckled into the arm supports. “So you don’t move or jostle us while you’re out.” Then the anesthesiologist came around to my IV side and pushed a syringe full of something clear into my arm.

§

Some days I forget there was ever a first part of my life in which I was someone else, a girl. Some days it’s like I’ve always been this way, flat-chested, with mannish mannerisms and a headstrong personality. But this is what I’ve grown into. What I grew up as was someone else. A person who no longer exists.

I know there is much to be thankful for about this body. It generally follows my orders. I do not have an immune disorder, my blood coexists happily with my cells, I do not require chemotherapy. I can run, skip, walk and jump to my heart’s content if I have an inhaler. But even so, for the first twenty-odd years of my life, I was largely unhappy, misunderstood and discomforted. I doggedly repeated inside my head, “You don’t have to be that kind of girl. You don’t have to be that kind of girl.” What kind of girl? Any kind giving me reservations about my gender. Didn’t want to be a pink princess kind of girl? Don’t worry, you don’t have to, said my brain. Don’t want to be a girl with crushes on boys? Don’t worry, you don’t have to be that kind of girl.

But I spent so long telling myself I didn’t have to be any particular kind of girl that I didn’t stop to think about what I did want to be. I was pretty sure I didn’t want to be a man, but I didn’t know there were other options. So I just kept telling myself, “Don’t worry, you can be whoever you want to be,” and felt all the worse for allowing people to see me as a girl.

§

I was in the shower (3) when it came to me: “regular” people don’t spend time wondering if they’re trans. It hit me in waves, turning my stomach and making my breath come faster. Why would you be asking yourself this question if you weren’t trans? Exactly. I cut the water off and stood blinking in the sudden silence. “Fuck,” I whispered, pulling aside the yellow-duckie shower curtain and stepping onto the mat. “Fuck, fuck, fuck,” as I grabbed my towel and wrapped it around my waist. “Oh no, oh no, please no...” I breathed, leaving the bathroom and going to my bed. I sat down, hair still dripping, and put my head between my knees. Staring at the tile floor between my feet, I let the thought settle. I am trans. I am a transgender person. Beyond that, it was hard to think. Fuck, fuck, fuck. There was no relaxation, no relief at finally having figured out the question I’d been wrestling with for, really, my whole life.

I was nineteen, in the fall semester of my middle (4) year of undergrad. I had a girlfriend who identified as lesbian. What would I tell her? I’d already come out as bisexual (age thirteen) and later gay (age eighteen). I was heavily involved in campus social life; many people knew me or knew of me. I’d have to reintroduce myself to the entire community, not to mention my parents. And my brothers. My baby brother had just been born the previous summer; if I moved quickly, he’d never learn my birth name.

I had fought against the truth without knowing it for so long. Now I had it right there in front of me. And it hurt. I would have to do so much work. I would have to ask everyone to call me by different pronouns, and graciously bear the errors people would inevitably make. And the hassle to change my name on all my legal documents. Was I really signing up for all this grief? I suppose I had a choice. I could have remained—outwardly anyway—a girl. But although I was terrified of my newfound knowledge, I felt so quiet inside. The questions I’d always carried and the discomfort I’d had with myself were quelled, like a child who falls asleep so deeply, so suddenly.

§

I got my first binder not long after. It was cheap, bought off an Asian website I couldn’t understand; just converting the measurements I’d taken of my chest brought me a week of hemming and hawing over the sizing. The Internet had recommended this site to me, said it at least wasn’t marketed toward cisgender men, the way “compression shirts” often are. I bought one in a half-tank style; it had Velcro on one side. I’d read I shouldn’t force my ribs into something tight right away, should give my body time to adapt, so I figured starting with an adjustable binder would be apt.

Forums and threads I’d been scouring told me I should work up to an eight-hour day of binding, I should never exercise in it, I should always have it loose enough to take a deep breath, and I should never sleep in it. (5) The day it arrived, I immediately took the package back to my room and ripped it open. The binder was stark white, with black mesh lining the front. The patch of Velcro was large, but not as strong as I’d thought it would be. I could tell it’d be itchy if my skin were exposed to it. I stripped off my t-shirt and slid into the binder right arm first. I emptied my lungs, tucked in my gut and closed the Velcro under my left armpit. Once anchored, I inhaled slowly. It was tight; my ribs couldn’t relax. But the front of my chest was flat, or nearly so. I opened the Velcro and filled my lungs, then anchored the binder around the circumference of my air-filled chest. When I exhaled, the cinch was looser, not painful. I can stand this, I thought. I stood before the full-length mirror on the exterior of my closet door. The binder stopped just under my ribs. I turned to the side. At worst you could tell I was binding; at best you might think I just had slightly developed pectoral muscles. I put my t-shirt back on. You could see the wide straps of the binder on my shoulders, and a small bulge under the fabric on my left side where the Velcro was, but those things were visible only if you were looking closely. The front of my chest was flat; where before there had been a gentle, feminine swelling, there was now a subtle, even negligible hint of chest. Tears came to my eyes. After half an hour of trying on shirts I tore myself away from the mirror. It was the first time in years I’d been at all happy with what I saw.

§

I was lying in bed one evening with my girlfriend Willa early on in our senior year. I’d come back to campus in August as Emerson, introducing myself again to all the Student Affairs staff and the forty- five residents in the dorm I was in charge of. Willa was asking how far I wanted to take this. “This” being my gender transformation. “I don’t really know,” I said. I stared at the white wall next to the bed, the Polaroids I’d clipped to a string hanging from two Command hooks, avoiding Willa’s gaze. “It’s one thing to change your name and pronouns, I get it. But are you going to like...medically transition?”

“I’ve never really thought about it,” I said. So far it had been enough to figure out I was trans and start binding. I’d had my nipples pierced as a sort of stop-gap measure: I still had breasts, but at least I decorated them to make them mine. (6) I hadn’t considered it further. “I might want to get top surgery,” I said, surprising myself. But as soon as I’d said it I knew it was the only thing I’d ever really wanted. From the time I was ten and my chest started to develop, I hated it. I remember thinking I was still too young; I wanted to be a child, or at least child-shaped, for a long time yet. I’d always thought my hatred for my chest, my body, was just a strong internalized misogyny; of course I thought myself inadequate, I reasoned. Don’t all women feel that way? But now there was a better rationalization for my self-hatred. I didn’t hate women. I just hated being one. “Well,” Willa said, and then fell silent for a moment. “If you went on T, I don’t think I could love you anymore.” I blinked. “Okay,” I said automatically. But then what she’d said sunk in a little more. “I mean, it’s not really your decision whether I go on T. I don’t know if I want to. I’m just saying, it’s not your call.” “I know. I’m just saying, too.” “Okay.” I don’t remember what happened after that moment. Later, I mentioned what Willa’d said to a few of my friends, who were appropriately horrified, but their reactions didn’t really sink in either. I just accepted the boundary she’d drawn, telling myself I had never wanted to go on testosterone anyway.

§

I started hormone therapy less than a year later, just a few months after Willa and I had broken up. (7) I wanted to lower my voice, as my main goal; I wouldn’t be upset at gaining muscle mass or some fat redistribution, either. At my first hormone therapy appointment, a nurse showed me how to inject myself, and I went home with a script in hand. I sent the prescription to a pharmacy in Portland apparently frequented by trans people all over the country; they mailed me a box with a large supply of needles and alcohol swabs and a solution of testosterone in cottonseed oil. Just two weeks after having seen the doctor, I was injecting myself with what is essentially a steroid. The dose wasn’t large, but the changes were quick. A month later, my voice started cracking; my skin was oily and my complexion ruined. My arms were gaining muscle and my shoulders broadening; I wasn’t even working out. I was only twenty, and in people that young, testosterone can make you grow; my mother swears I gained a whole inch. By month four, all my shoes were too tight. I’d had to buy new pants, too, from the men’s section, as the short inseams in the women’s styles were pinching my clitoris, which had been growing steadily.

The last straw was when I started to sprout facial hair. I got my roommate to teach me how to shave, did it once or twice, and declared surrender. The hormones were turning me into an alien. I couldn’t control my own body, didn’t know what would happen to it next. My voice had dropped from an alto to a tenor, and this effect would be more or less permanent (8); all the others I could live without. I stopped taking the T with little ceremony, and for a few years, that was all the medical transition I had the stomach for.

§

By the time I got serious about top surgery, I was twenty-four. I had just dropped out of a PhD program and had little else to do. Trump was already president, and I knew he’d roll back protections for trans people, so I busied myself finding a surgeon who’d help me. My mother is a public school teacher in New York City and has great health insurance (9); thanks to the ACA, her plan would cover all costs associated with gender affirmation surgery. (10) I would remain on her plan until I was twenty-six, but scheduling major surgery can take months. My age and Trump’s presidency made my quest all the more urgent. At the first appointment with the first surgeon, I explained I was non-binary. He nodded as I spoke, his assistant taking notes as he directed me to pose for pictures of my chest. “Those piercings will have to come out,” he mentioned, and I looked down at my nipples, studded with barbells. “That’s okay,” I said. “So, to make things easier,” the doctor said, “we’ll say you’re a trans man.” “We’re going to lie?” “It just explains things better. Do you have a therapist?” I did. And a psychiatrist. “They should write letters of support for your file. You know, about how long you’ve identified this way and how surgery is medically necessary for you.” This wasn’t surprising; I’d anticipated this need and wasn’t worried about obtaining the letters. But the surgeon’s ease in proposing we lie about who I was...this concerned me. But he was the doctor. He knew best, I supposed, and I acquiesced to his proposed method. I coordinated with his assistant and later sent her the required letters and paperwork. I didn’t hear back from either of them for two months, even after sending multiple emails. Finally, I called. His assistant was apologetic. The hold-up wasn’t on their end, she said, it was the insurance company. My case had been in limbo for some time, waiting to get approved, but just recently the insurance company had decided I didn’t need approval after all, because I was non-binary (my therapist and psychiatrist had of course used ‘they’ for me in their letters) and the surgery was only a mastectomy. “So I don’t need approval?” “No, you’re good to go,” the assistant confirmed. And when was she planning on telling me this? “This just happened last week. I was going to call you.” Another week went by before I was suddenly told this doctor was full and would not be able to perform my surgery over the summer like we’d planned. I was angry at the lack of communication, but it wasn’t all a loss. The insurance company had decided I was good to go. I just needed to find another doctor. I eventually managed to make an appointment with another surgeon. The only problem was that she mostly practiced in Long Island. For the first appointment I took a Lyft all the way there and all the way back, eighty dollars each way. There was nothing else to do; Lucia was working and there were no good public transportation options. The first appointment went well. I met Dr. V and her assistant Maggie. Dr. V took pictures of my chest as I explained my gender identity, how long I’d felt this way, that I’d tried being on hormones and now the next step was top surgery. She didn’t balk at the word non- binary. She did seem hesitant as she explained I would have significant scars and lose feeling in my nipples. I knew this, I said. Still, she showed me pictures of other patients, their before-and-afters (no faces). It was true; the scars from a traditional mastectomy, in which the surgeon cuts across the bottom of the breast, are pronounced. Luckily, after snapping photos, Dr. V declared I was a good candidate for a keyhole surgery. This is a less invasive method where they cut around the bottom half of the areola and remove the breast tissue through that opening; it’s usually only done with smaller-chested patients. But I’d still lose feeling in my nipples, at least some if not all. I didn’t mind, I said. I wanted this done.

With Dr. V and Maggie, we set up my pre-op appointment. I asked if it was possible to do it in Brooklyn, but Dr. V said it had to be done at the same facility where they’d do my surgery, for liability purposes. I’d have to come back to Long Island in two weeks to get blood tests and a chest x-ray. “All right,” I said, mentally calculating how much I’d be putting toward Lyft fares. Maggie said she’d make the appointment for me, and I left that meeting feeling vindicated. I was on my way to a new body. To disguise my apprehension, I started referring to the surgery as my ‘chesticle festival.’

§

Two weeks later Lucia, who’d taken the day off from teaching in Newark, drove us in a red Zipcar to a hospital in western Long Island. When we walked in, the front waiting room was full of elderly people in gowns. The security guard directed us to the pre-op wing. When we walked into the pre-op waiting area, all the old White people in there stared at us. The White nurse at the desk, when I gave her my name, looked at me blankly. She conferred with someone behind the desk. “Just have a seat for a minute,” she told us. We waited about half an hour before another White nurse called us into a back room. “So, I just wanted to let you know what’s going on,” she said. Lucia and I exchanged glances; this didn’t sound good. “We don’t have any record of your pre-op appointment,” she said apologetically. I was dumbfounded. “We also don’t have any record of you on the surgical list. When did you say your surgery was?” “June 14th,” I said. By this point it was nearing the end of May.

“Yeah, you’re just not coming up in the system. Who’s your doctor?”

We confirmed that my doctor did in fact sometimes practice at this hospital, but for whatever reason, my appointments had not come through. “Is there someone you can call about this?” the nurse asked sympathetically. “I just feel awful that you ladies came all the way out here.” Sure, I said. I would call Maggie, the surgeon’s assistant. I had to leave the building; there was no service down in the pre-op wing. Maggie didn’t answer, and I left a confused and displeased voicemail asking her what was going on. I returned to the pre-op waiting area, where Lucia was still sitting with my things. The sympathetic nurse approached us with two coupons in her hand. “Here,” she said, giving them to me. “So you can go get a bite at the commissary.” The coupons offered us each five dollars in free food. We looked at each other and understood we were essentially being kicked out.

The cafeteria was sad: plastic tables and chairs, cold tile floors, no hot food to speak of. The fare was all sandwiches and pre-packaged yogurt parfaits. I think I had a piece of dry cake. We sat there for another hour. Every fifteen minutes or so I went back up to the lobby to see if I’d gotten a call or voicemail from Maggie. Nothing. Eventually the same nurse came to look for us. “We finally heard from your doctor,” she said. “The short of it is, your surgery was moved to another facility. So you can’t have your pre-op done here because you won’t be having your surgery here.” I tasted bile in my throat; I wanted to punch something. Lucia had taken the day off, rented a car, and we’d wasted close to four hours. “Why didn’t anyone tell me this?” I asked. The nurse looked uncomfortable. “I don’t know,” she said, finally. “Call your doctor.” We left a few minutes later, got into the Zipcar and headed back to the city. I cried in the passenger seat. Lucia glanced at me now and then. “It’ll be okay,” she offered. I knew she was trying to help, but I was so angry. I just cried harder. “Why,” I sobbed, “didn’t she do her fucking job? All she had to do was make one appointment! Or fucking call me!” “I know, honey. I don’t know why. It’s messed up. I’m sorry.” Maybe a few hours later, maybe a day, I eventually got a call from Maggie, apologizing profusely for the mix-up. I accepted what she said curtly, replying with only what was necessary. She said my surgery was moved to another hospital called Mercy, and my pre-op would have to be done there. “No way,” I said. “I’m not going back to Long Island after wasting a day already. It’s just a blood test and a chest x-ray. Find me somewhere in Brooklyn.” She vacillated but eventually agreed. She’d call me back with the details, she said. After a few hours she let me know my pre-op appointment could be completed at a hospital in downtown Brooklyn. The appointment was on Monday, the surgery on the following Thursday. We’d be cutting it close, she said. My brain retorted, whose fault is that? I thanked her and hung up.

§

The pre-op appointment went well; I have no distinct memories other than the surprise on all the nurses’ faces when I mentioned that my surgery was later that week. “We’ll do our best,” they said, and I shrugged. I was young, healthy; neither the blood tests nor the chest x-ray were going to turn up anything worth canceling the surgery over. All that mattered was getting there. The night before my surgery, I went to bed with butterflies in my otherwise-empty stomach and stared at the ceiling. Lucia, exhausted from her long day at work, was already snoring softly beside me. Tomorrow, I would be a new person, I thought. My real self. Four hours after going in for surgery, I woke up, feeling like I’d just nodded off for a minute. “Did they do it yet?” I mumbled. I was in a different room. Lucia was sitting at my bedside with a magazine on her knee. At my voice she looked up and smiled. “It’s over, honey. You did great.” “It’s done?” But I felt nothing. My blankets were unmussed. My toes were still frozen. “Are you sure?” “Si, mi amor.” She was trying not to laugh. “It’s all done.” Once the nurses noticed I was awake, they descended upon me again. “How do you feel? Where is your pain at?” “I don’t know, I don’t feel anything.” They insisted it would be better for me to “stay ahead of my pain” by taking the prescribed Percocet. They shook the bottle at me and put it into a paper bag that they handed to Lucia. Now that I was awake, they said, I was free to go as soon as I felt ready. They gave me my clothes back and drew the curtain around my bed. I dressed myself slowly, gingerly, with Lucia at my side, carefully watching my balance. I still hadn’t eaten. The drains, clear plastic bulbs connected to tubes that disappeared into my bandages, swung against my stomach. They were pinned to the surgery bra I found myself wearing, which opened in the front. I wondered who had dressed my sleeping body, whether they were careful. As I walked out of the hospital, holding Lucia’s arm, my body felt lighter, although it could’ve just been psychological. It was 9 p.m.; we’d been at the hospital for about twelve hours. Three or four hours later, I felt a dull ache inside my bandages. That night, I did take a Percocet, because I didn’t know what else to do. I slept almost immediately, and woke early the next morning to empty the drains, which had filled with a bloodied yellow fluid. I had to measure and keep track of the amount of fluid collected every day, multiple times a day. If the drains were not filling properly, I should let someone know. The Percocet made me feel like a zombie. On the day after the surgery, I woke up from my afternoon nap in the same stupor I’d been in since the morning. After the second day, I stopped taking it and switched to cannabis for the pain. I thought, not with fondness, of the way the nurses had pushed me to “stay ahead of my pain,” which as far as I had experienced, was not excruciating. And what was wrong with feeling pain? At least this pain I would feel for a good reason, instead of the usual torture of living in this body.

§

I was not to raise my arms above my shoulders, nor carry things. More than once, I had to stop myself from hugging my cat Julius to my chest. I learned to tape the drain tubes to my belly, a few inches down from the incisions in my sides where the tubes disappeared; this way they didn’t pull on the stitches or tug at my skin. This small adjustment made living with the drains bearable, and slowly the bulbs stopped filling every night and the fluid was no longer colored with blood. After the second week, my first post-op appointment loomed. I was terrified I’d be told something was going wrong, I wasn’t healing well enough. My friend Zooey drove me to the office in downtown Brooklyn and came into the room with me. I knew I’d be too nervous to remember anything the doctor said, so Zooey was going to take notes for me. The White nurse who attended me was a stranger, peppy and a fast talker. She took off the bandages carefully, asking me all the while if the removal of the tape hurt. No, I said, it wasn’t that bad. She commented that most people said the tape hurt the most. She said she was surprised I was taking it so well. Zooey and I exchanged bemused smiles. When the bandages were finally off, I looked down and saw my chest for the first time. I was horrified. The stitches were still in and coated in dried blood. My left nipple was sagging as if it were about to fall off. Was that normal, I asked anxiously, and would it get better. The nurse laughed and said everything looked fine. What did hurt was the removal of the drains. The nurse stepped behind me and clipped the stitches, holding the tube in place, then tugged sharply on the tube. I felt something slither under my skin and heard a slick, soft pop as the mouth of the tube exited my body. She came around to my right side and did the same; this time, I felt the flat end of the tube, while it was in my chest, turn over. As the nurse pulled it out of me, my stomach turned. The sensations were too strange. I bent over in pain; a hollow in my chest was throbbing. “That one hurt,” I noted to the nurse, who remarked again how that was not the usual experience.

She re-bandaged me with fresh gauze over the drain tube hole, affixing long lengths of tape to my sides and back. As she did this, she gave instructions on aftercare to Zooey, who was taking notes on her phone. I couldn’t concentrate on what she was saying; my chest was still throbbing and I was trying to avoid the sight of my nipples, crusted and sloughing as they were.

§

When we got home, I showed my new nipples off to Lucia the first chance I got, even though I thought they looked terrible. “I’m so proud of you, honey,” she said, and I felt like I’d done nothing, just lay back and let myself be dissected, but I smiled at her anyway. The simple pleasure of being able to lift my shirt and flash my chest without caring was elevating my mood. A few nights later, it was time to take off the bandages and let the tube incision sites air out. I stood shirtless with my back to Lucia, who sat on the toilet. As she started to peel off the tape, I cursed loudly. It was agonizing. The tape was amazingly sticky, and when she pulled it away from my skin, it left an angry red patch stripped of the fine blonde hairs on my torso. “There’s a lot of tape,” Lucia commented. “Like, not all of this is necessary for your bandages.” She cautiously picked at the edge of one strip of tape, trying to get enough to really pull on. “That fucking bitch,” I yelled, trying to stay still even though I wanted to pull away from the pain she was inflicting. “What? Who?” Lucia asked. I recounted what had happened at the last appointment; through it all Lucia kept peeling tape from my skin and I’d howl in pain, cursing the nurse at full volume. “The neighbors will hear you,” Lucia hissed. I knew she was thinking of the couple downstairs, who had four small boys and dressed them up for church on Sundays. I flipped on the bathroom vent in response, but it didn’t do much to drown me out. By the end, I was crying, red tape marks streaking down my sides and back. “One more piece,” Lucia said. I begged her to do it quickly, let me out of this misery. But she refused, saying it’d damage my skin, and she was probably right. “I’m sorry, I’m really sorry,” she said as she pulled slowly on the final strip. “Why would she do this to me?” I moaned, face red and wet with tears. “I don’t know, honey.” Another few seconds and it was over. My skin was covered in glue residue, but the wounds where the drain tubes had come out of my chest were small. One was already closed, and the second not far behind.

I don’t remember what happened after, nor how long my skin burned, how many days I carried anger for the nurse, how often I wondered what joy she got out of covering me in tape.

§

My final post-op appointment, a follow-up with my surgeon, wasn’t long after. It had been three or four weeks since the surgery. I took the bus to her office downtown by myself. I waited for only a few minutes before being shown into an exam room. I took off my shirt with a newly- developed sense of casualness. Dr. V came in and put on a fresh pair of gloves. She came over to me and probed my chest with two fingers, asking if it hurt. There was a part that was sore, on the left side. I’d been brushing Julius a week or two before and the heavy brush had stuck in his fur. I tugged it; it came loose quickly and flew back, hitting me in the chest. It had been extremely painful; now, there was a visible indent under the skin, above and all around the nipple. “I brought your nipples lower, and made them more oval, I don’t know if you noticed. It’s more masculine that way.” I hadn’t. As a general rule, I avoided looking at myself in the mirror; it was depressing. She brought out my before pictures and showed me for comparison. The nipples were a different shape, it was true. At least in Dr. V I had someone I could trust to do their job. “You can expect numbness for up to a year,” she said, “especially in this spot here,” indicating the sunken patch on my left side where I’d hit myself. “A whole year?” “Yes. But the skin should tighten up and stop sagging. I don’t know if you’ll have much sensation though. You’ll be able to feel things through your skin, of course, but the larger nerves underneath won’t regenerate.” “That’s okay.” She took pictures of me for the file and proffered her ungloved hand for shaking. “Well, that’s it.” “Thank you so much,” I said, grasping her hand tightly. “Seriously. Thank you so much. It feels amazing.” She smiled. “You won’t need to see me again. You’re fine. You’re free.” I left the office and got a Citibike at a nearby docking station. It was sunny, and I could feel myself sweating as I pedaled up the Dekalb Avenue hill. Beneath my shirt, I felt the light, wonderful sensation of being braless, no elastic encircling my ribs, no straps rubbing my shoulders, and best of all, no breasts on my chest. It was still tender, and I was afraid of overexerting myself, but after I’d crested the hill, the ride was smooth, without much traffic. I parked the bike at the docking station at the southwestern end of Herbert Von King Park. We lived just on the other side. The grass field was full of families enjoying the sun, the playgrounds teeming with children. I walked through the park chest-first, stance open and strong.

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(1) This, the ability to choose to ‘not deal’ with one’s identity, is White privilege.

(2) Lucia wasn’t usually in charge of policing how people referred to me, but we hadn’t discussed how to deal with this issue on this particular day, and I was grateful she was taking charge. After much miscommunication among the nurses, eventually someone printed out a large label that said “Just call them Emerson” and put it on the binder with all my charts.

(3) As a general rule I hate showers. I joke that it’s because I don’t like to get wet, and I don’t, but it’s mostly because I can’t stand to be alone with my nudity. So it was a cruel irony that the thought struck while I was bathing.

(4) I started the year as a sophomore, then transferred credits and became a junior halfway through the first semester.

(5) These recommendations, made by medical professionals and well- meaning trans people across the Internet, aren’t always attainable. It’s not possible to appear flat-chested and be able to take a deep breath in your binder, especially non-adjustable ones. Even if it’s adjustable, to leave it loose is to defeat the garment’s purpose. So while they tell us to be careful, it’s a weighing of two evils, and people usually, and especially at first, prioritize easing the pressing dysphoria over potential long-term complications.

(6) I thought that by creating wounds and forcing myself to take care of them, I’d develop an affinity for my breasts, these unwanted appendages getting in my way. It worked okay. At the very least I was able to sometimes feel sexy.

(7) Willa no longer being in the picture wasn’t the only impetus for starting hormones. I had recently moved out of my mother’s house and felt freer to pursue my medical options. I was also manic and thought all the ideas I was having were marvelous; they were, largely, not.

(8) Testosterone makes the vocal folds thicken and lengthen. This is one of the only changes doctors are willing to call permanent; most other things, if hormone therapy is stopped, eventually revert. It depends on the person. (Estrogen does not have the opposing effect on the vocal folds.)

(9) Thanks to the efforts of her union, no thanks to Michael Bloomberg.

(10) I paid the insurance company approximately $300 for a surgery that was billed at $30,000. There were other costs related to the process, but on the whole I was extremely fortunate. Thanks, Obama.

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EMERSON HENRY works with migrant youth in Portland, OR. Their work has appeared in Crazyhorse, Emrys Journal, Crab Fat Magazine, Emerson Review, Coffin Bell Journal, Bayou Magazine, Peregrine Journal and Foglifter. They have been nominated for the Pushcart Prize and PEN/America’s Robert J. Dau Short Story Prize for Emerging Writers. They studied writing at Sarah Lawrence College and are pursuing an MFA at Portland State University.