True Trans by Lee Thomas
2018 CBC Nonfiction Prize shortlist
Lee Thomas has made the 2018 CBC Nonfiction Prize shortlist for True Trans.
You can read True Trans below.
This story contains strong language and mature subject matter.
The doctor hates me, and I know it.
"So you're here to talk about getting top surgery." He says this with a measured lack of emotion, but he glances at me. Briefly, skeptically.
I nod meekly. I hate being meek. I don't know where it comes from, or, I guess, I don't know where my courage goes. I remember learning that cold is really the absence of heat, darkness the absence of light.
I am wearing my best androgynous outfit. Men's boots. Boyfriend jeans. A baggy sweater. No makeup, not even concealer. Can't risk it.
Top surgery. The surgical removal of breasts. Chest masculinization. I've had to learn these terms, a new language — T means testosterone, hormone therapy. Phalloplasty, the construction of a penis from skin taken from your forearm or upper thigh. Not my goal. Binder, a constrictive cloth vest used to squash down breast tissue. I prefer to just double up on sports bras. The doctor doesn't ask, but I know he notices.
I take a deep, quivering breath. On the drive to the clinic, I'd blasted the song True Trans Soul Rebel on repeat. I'd hoped the courage of Laura Jane Grace, the transgender frontwoman of Against Me!, could be carried through the music. I felt full of potential, there in the parking lot. The beginning of my transition journey. I felt brave.
Under the fluorescent lights of the doctor's office, I don't feel brave. I can't hear the music. I try to find the lyrics, I know they're somewhere in my head, but all I can hear is the buzzing of the lights and the nervous shuffling of my own feet. The doctor is talking and I want to pay attention. I know this is important. I need to focus.
I felt full of potential, there in the parking lot. The beginning of my transition journey. I felt brave.
The doctor explains that there are questions that he needs to be able to answer before he can sign off on this procedure. He explains that this surgery is about providing a medical solution to a medical problem and he needs to be able to diagnose if the problem is there before he can make a recommendation. He does not take this recommendation lightly, he tells me sternly. I nod. He says the government has prepared a form. He has some questions for me. I am ready.
He asks if my gender identity has been stable for a significant period of time. A form question. I've come prepared. My gender therapist and I have talked about this. "You can show all the doubt you want within these walls," they had told me, "but when you get to the doctor's office, you have to be certain." I am certain. I am certain, but my voice trembles as I tell the doctor about being a child and not understanding that I was different from the boys, about changing my feminine name to an androgynous one, about how the first signs of puberty launched me into a decade of bulimia — a futile attempt to keep my body small and wiry. I told him that I could never understand why my classmates would compete over the size of their new breasts while I fantasized about slicing mine off with a razor blade.
The doctor interjects, "How often?"
"How often did you fantasize?"
I don't know how to answer that question. It was 12 years ago, I explain. It's hard to remember, exactly.
"That's the thing, though." He shifts in his seat and his tone changes. "For most people, it's not hard to remember." He corrects himself. "For most transgender people." He over-enunciates transgender, so I hear every syllable. The hiss of the s, the click of the d. Damning syllables, condemning me to a life in this body. I wish I could see what he's writing down, but I don't need to know the reason to know the ruling. I'm not true trans.
He over-enunciates transgender, so I hear every syllable. The hiss of the s, the click of the d. Damning syllables, condemning me to a life in this body.
I begin to panic. This is not going how I'd practiced.
"So how did you cope with this 'dysphoria?'" The doctor asks. I can hear the air quotes. The diagnosis I need, hanging just outside of my reach. The distance between where I am and where I could be, a hairline fracture made insurmountable by his medical doubt. He continues, "because there should be evidence of distress, like an addiction or a drinking problem or—"
"Or an eating disorder?" I am desperate, but it comes across as sardonic. Eating disorders are common in the trans community. I remember reading that somewhere.
"Maybe." He writes something down. "But how do we know you're not just rewriting history? Retroactively applying your experiences to fit a trans narrative?"
I say nothing. I don't know that. How could I know for sure? Did the fact that I didn't know mean that I was just making everything up, as he clearly suspected? In that moment, I hated him back for making me question myself. I'd worked so hard to be sure of this.
I feel my eyes get hot with tears and frustration. Why the fuck can't I do what I want with my own body? I've got a psychiatrist, a gender therapist, a team of medical professionals saying I am sane enough to make this decision. I chew my inner lip until I taste blood, and then I chew harder. I hate that I'm crying. I know the doctor sees it as feminine, as proof that I'm unstable, as all the evidence he needs to deny me what I'm asking. He points me to a box of tissues on his desk. I am not the first weepy patient he's seen today. He jots something down, then sits in dispassionate silence while I press my knuckles into my tear ducts.
"I have more questions. What are you hoping to achieve from this surgery? What if you regret it? When you go to a restaurant, what do you want the server to see, a man or a woman? What does being nonbinary even look like to you?"
I grow smaller with each question, until I am nothing at all. I sit in silence, willing the tears to evaporate, to turn to steam and to take me with them.
The doctor runs a hand through his hair. He is frustrated that I do not have these answers, but he is a professional. He says, too calmly, "You're going to be a test case for this province, trying to access surgery without undergoing hormone therapy first." He doesn't need to add, so you'd better get your story straight.
I want hair and muscles and voice breaks. I do.
I tell him frantically that if I need to take hormones first, if that's a hoop I need to jump through, I'll do it. I want to take them eventually, anyway. I want hair and muscles and voice breaks. I do. But the thought of having both body hair and breasts at the same time feels wrong.
"Why does it feel wrong?" The doctor asks. There is an edge to his voice. His 15 minutes of professional patience is nearly at an end. "You need to be able to answer these questions."
I'm whimpering now, begging, pathetic. He asks why the psychiatrist increased my Wellbutrin dosage. He suspects now that I am too mentally ill to make this judgment call. I am caught between not seeming distressed enough to deserve surgery, and yet too distressed to decide for myself. I point this dilemma out to him with a quivering voice. He agrees.
"It is what it is," he says. "The system is not perfect."
He tells me to come back in two weeks.
Laura Jane Grace is waiting for me in the car. The music is deafening.
Who's gonna take you home tonight
Who's gonna take you home?
Does God bless your transsexual heart?
I scream along, and my voice is ragged. For a moment, I can pretend that it's breaking.
Read the other finalists:
- If I wax poetic the pain feels worthwhile by Lily Chang
- How to Catch a Nightcrawler by Kat Main
- Acceleration by Anastasia McEwen
- Easy Family Dinners by Sandra Murdock
About Lee Thomas:
Lee Thomas is an international speaker, writer and advocate currently based in Calgary, Alta. They speak to groups of all ages and sizes about mental health and LGBTQ+ issues, with a particular focus on stigma reduction and youth mental health. Thomas is a mental health First Aid instructor, ASIST trainer, two-time TEDx speaker and founder of the #MyDefinition poster campaign. When they are not doing mental health or LGBTQ+ stuff, you can usually find them updating their dog's Instagram account (yes, really).