Three months of planning and then living Pride Month in Bucharest are behind me. The year 2012 is beginning to divide nicely into quarters with no forethought on my part. From January through March I concentrated on voice. It was a good way to spend the long, snowy winter in Romania, and it was the best possible use of time and money. There will always be more work to do, but today no one ever mistakes my voice as anything other than that of a woman. Given the expense of transition, the money and effort one puts into voice comes off as a relative bargain.
April, May, and June went to Pride. So what comes next for this transgender Foreign Service Officer (FSO)?
The answer, dear friends, is that I'm looking for a spa where I can receive SPA therapy. I wish I could have invented the term spa therapy, but full credit belongs to Caroline in the UK, whose web journal Time Regained has been an enjoyable means for me to learn from the experience of someone several years ahead of me on the road to transition. In Caroline's phrase, SPA is an acronym standing for sexual preference adjustment. Gender confirmation surgery (GCS) is a much softer description of the process we go through than is the clinical sounding phrase sexual reassignment surgery (SRS). Although Caroline's name includes the word sexual, I like it for its whimsical take on what is a very complex medical procedure. I do like the thought of looking not for a surgeon but rather a special type of spa.
For those who have been reading and wondering, the answer is that I do intend to go for spa therapy. I have been researching, reading, and corresponding for several months now, much longer if you add that I was reading and researching as early as 1975. It's just that this time there is nothing distant, out-of-reach, or hypothetical about my research. My intent is to check in at the spa of my choice early next year not only for GCS but perhaps also for some degree of facial feminization surgery (FFS). I have already put in for six weeks of medical leave, and my finances will be in order, albeit just barely. One benefit of having lived through an expensive legal crisis in 2007-11 is that I learned to live on very little and have been able to save funds for surgery faster than I have ever saved in my life.
The question is, which spa should I choose? It didn't take me long to narrow down the geographic options. There are only two locations I would consider: Philadelphia and Thailand. Three of the best known GCS surgeons in the US happen to be in the Philadelphia area: Dr. Sherman Leis (http://www.thetransgendercenter.com/), Dr. Kathy Rumer, and Dr. Christine McGinn. I will see all three of them when I'm in the US on vacation in early August. I have already corresponded or talked directly with all three, and I find reasons to like each of them. Dr. Leis is the most senior of the three. My friend Shannon went to him for GCS several years ago and has told me of her experience with him -- all of it positive -- in great detail. Dr. Kathy Rumer (http://rumercosmetics.com) had a first career working for Lockheed, and since I worked on the Lockheed-built Hubble Space Telescope for longer than I've worked on anything in my career, I feel there is something appropriate about one former engineer putting herself in the hands of another for surgery. Dr. Christine McGinn (http://drchristinemcginn.com/) herself transitioned from male to female, which gives her an insider's understanding of the entire experience.
Thailand offers a smorgasbord of options ranging from cheap and scary to as expensive and good as surgery in the US. One or two of them may be better than any U.S. surgeon. I began by contacting several of the Thai surgeons, but with time I whittled the pool down to two: Dr. Sanguan Kunaporn in Phukett (http://www.phuket-plasticsurgery.com/home.html) and Dr. Suporn Watanyusakul in Chonburi (http://www.supornclinic.com/).
All of the surgeons I am considering have excellent reputations and almost always ecstatically happy patients. The U.S. surgeons, as I understand it, all practice the standard penile inversion method of vaginoplasty. This technique has been around since the beginning and was even being performed at the University of Virginia's medical center when I was a university student the mid-1970s. The essence is obvious from the name: a vagina is created by inverting the penis, a clitoris is created using the head of the penis, and scrotal tissue is used to create the labia. The Thai surgeons have all developed their own variations on the standard technique, and Dr. Suporn has turned everything on its head with his non-penile technique that uses scrotal skin to line the new vagina and creates the labia from penile material.
My thinking on each of the five surgeons has cycled several times. Each has been No. 1 on my list at least once. I find good arguments in favor of each and in the end will decide based on the best information I will have at hand on the day I commit. That day will come very soon now, no later than mid-August, as almost all the surgeons I named have waiting lists of 3-6 months or longer. Thus surgery in February 2013 dictates that I reach my decision next month.
And why, you ask, do I feel I must check in at the spa of my choice in early 2013? The answer is elementary, Dear Watson: the Foreign Service rotation cycle. In Romania I have a support system both at work and in all of my life that will be very important in my early weeks and months of recovery. I expect to leave Romania for good in June 2013 and will then take up a one-year assignment in Washington, DC, where my support, as wonderful as it is, is not as developed and all-encompassing as it is in Romania. Moreover, I don't want to inform my new supervisor on my first day of work that, "Hey, I thought you should know that I plan to request six weeks of leave for GCS surgery later this year." Life will be simpler and healthier all around if I complete GCS months before I depart from Romania.
Then there is the small matter of medical clearance, which all of us must have as FSOs posted overseas. Even small medical matters can lead to one's clearance being reduced or removed, so this also dictates that I complete GCS well before going overseas again, presumably after the completion of my Washington assignment in mid-2014. By completing GCS in early 2013, I will have nearly a year and a half of recovery behind me before I must again go before a medical clearance board. That should be enough to satisfy the concerns of any doctor on the board about post-operative complications that might happen while I'm posted, let's say, to Tajikistan or some other country far removed from Western hospitals.
Finally there is the matter of the emotional experience and support. If I choose to have surgery in Philadelphia, then I know I can count on two of my sisters, several friends, and my son, all of whom live in the Washington area. If I choose Thailand, then I will need to factor in the expense of paying for a friend to go with me as support. You may be surprised to hear that I do not consider this to be a negative side of opting for surgery in Thailand. Whether this applies to me or not, a friend by correspondence reminded me that no matter how much one's close family is supportive, for them GCS may still have overtones of being the final stage in a dying rather than a moment for celebration. Also, at several of the Thai clinics, GCS surgery is a communal experience as people come from around the world to complete one of the important final steps in their medical journeys to a new life.
Decisions, decisions. Stay tuned, dear friends, as Robyn enters this third quarter of 2012, the first half of which will be dominated by medical correspondence, in-person consultations, and an ever more detailed spreadsheet to compare and contrast. In the end, however, I already know each of the surgeons I have listed is excellent. From there I enter into the realm of imponderables and feelings where the heart rules as much as the head.
I can already see it. On the evening of August 7, my in-person consultations done, I will board a midnight train in Philadelphia for a fourteen hour journey north to my adopted state of Maine. By the time New York has slipped behind me and we cross into New England, I will have made my choice.
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