Bucharest Farewell

It must have been late February when I first asked Daniela at the Romanian LGBT rights organization ACCEPT, “When will GayFest take place this year?”  In 2012 it was the last week of June.  I already knew that I would be departing Bucharest in mid-June, so I followed up by pleading, “Please have it in the first half of June so that I will still be here.”

I will never go so far as to say that my personal needs have any influence on the scheduling of significant public events, LGBT or otherwise, but I was more than simply pleased when the answer came that ACCEPT was trying to schedule GayFest for the first week of June.  It felt as though a party was being scheduled to ease my emotions as the day of my final departure from Romania approached.

It's no exaggeration to say that GayFest was bigger and better this year.  Our Embassy contingent from Gays and Lesbians in Foreign Affairs Agencies (GLIFAA) had learned from last year's experience, and our Cultural Affairs office was fully engaged.  SC, newly arrived in Bucharest, took over from me as GLIFAA Post Representative on May 1, and LQ, FT, and SE jumped in actively.  TT and a number of other straight allies were there as well, as was our new human rights officer LQ. (By the way, I offer a complimentary Romanian covrig [pretzel] to anyone who can decipher the code I use for naming friends without actually naming them.)

Diplomatic Reception with Chargé Duane Butcher,
Buhuceanu from ACCEPT, Author Kevin Sessums, and
Finnish Ambassador Ulla Väistö

One big change for our GLIFAA contingent this year was that we reached out to other diplomatic missions.   (Big thanks to SE for that idea!)  We sat around the table with colleagues at a Bucharest restaurant in late March to talk it over.   As a result, the diplomatic reception on the eve of the June 8 Pride March was co-hosted.  The venue was the residence of the U.S. Ambassador, but the invitations were jointly sent out from the U.S., UK, Swedish, Finnish, Austrian, and Israeli embassies.  Since we are currently without a U.S. Ambassador, our Chargé d'Affaires Duane Butcher hosted, and Finnish Ambassador Ulla Väistö delivered remarks to over 100 guests from the community of Romanian LGBT advocates and allies.

We opened our own Pride celebration at the U.S. Embassy the week before GayFest by hosting a digital video conference with former Ambassador Michael Guest before an audience of LGBT community members, journalists, and representatives of non-governmental organizations.  The first openly gay ambassador to be confirmed by the U.S. Senate, Ambassador Guest is well remembered and highly regarded in Romania.  In a deeply personal hour and a half of give and take, Amb. Guest told about his family life, what it was like to serve in Romania accompanied by his spouse, and why it was that he left the Foreign Service in 2007.   His words left a mark, and they were cited by Sasha, a young transgender activist in our audience, when he was interviewed the following week in the newspaper Romania Libera (http://www.romanialibera.ro/opinii/interviuri/interviu-cu-sasha-ichim-transsexual-sunt-judecatori-care-spun-ca-suntem-niste-monstri-304217.html).

Kevin Sessums with Bucharest LGBT Activists

This year we also had a special Embassy guest speaker.  I first met Kevin Sessums at the LGBT workshop in Tirana a year ago. (See Proudly from Tirana.)  Author and editor, he wrote in his memoir Mississippi Sissy what it was like to grow up gay in what at the time was the most conservative, segregationist state in the US.  It was not nice.  Kevin worked with the Embassy and with ACCEPT to inaugurate LGBT bookshelves, the first of their kind in Romania, at the Carturesti bookstores in Bucharest, Cluj, and Constantsa.  When he read from Mississippi Sissy before a standing room only gathering in Bucharest, he spoke with such passion and animation that at one point he slammed his fist down, in the process cracking a glass table top.

The week belonged not to us at the Embassy, however, but to our Romanian friends who worked so hard and so well to bring off a week of events that included movies, discussions, exhibits, and a bigger and better Pride march than had ever before taken place in Bucharest.  For the first time, the march took place in the city center on the street that is Bucharest's equivalent of embassy row in Washington, DC.  Upward of 400 people participated, noticeably more than last year, and the energy of those who marched was higher.   Everyone remembered the incident in February when protesters prevented the showing of an LGBT movie.  (See Home Sweet Home in Romania.)  The police were out in force, but the feeling was one of celebration.  The march route ended in Kiseleff Park just around the corner from my apartment, but rather than participants simply dispersing, there was an after-march Diversity Zone in the park with speeches and a party atmosphere.  GLIFAA had its own table in the zone, and SC officiated by distributing free water, soda, granola bars, and literature.

At the Pride March

It really did feel as though my Romanian friends had arranged the entire first week of June to keep my mind away from leaving.  When the movers came to pack me out on May 31, TJ, BD, PE, TH, and several other friends came to keep me company, to keep an eye on the movers, and to keep me in the moment.  They made fun what otherwise would have been a very sad day.

GLIFAA Table at the Pride March

Most happily, I found peace over those final weeks with my emotionally adopted adult child.  Our relationship continues.  If anything, what we both experienced together and individually has made the bond stronger.  My first post-transition relationship crisis has passed. 

GayFest over, my final week in Romania had arrived.  There was no holding back the emotions now.  The day after the Pride March, friends lured me to ACCEPT to watch a movie.  As the evening went on, more and more people came.  They had conspired to make this my farewell evening, a chance for last hugs and photos.  There were more than a few tears.

My last day at the Embassy was Wednesday the 12th.  My  checkout list complete, I made the rounds from office to office for goodbyes and goodbye hugs.  I took one final long look as I walked out the door for the last time.

Then my phone rang.  "We're waiting for you in the park!"  It was Sasha.  He and several others had gathered in Kiseleff Park and were waiting for me.  We sat and talked until the storm clouds came.  Then we adjourned to my apartment and ordered pizza.  It was the last party in a home that has seen many parties and evenings with friends.

Thursday, my last day, had come.  There was one last visit to Mirela, the magical electrologist of Bucharest, and one last shopping trip.  Ma Ni, a new friend, helped me with some hair products and eye makeup.  When the Embassy car came at 4:30 on Friday morning, she and my adopted daughter went with me to the airport.  My bags checked, we sat over coffee until the time had come. . . .  I won't describe the parting scene.  I'm certain you can see it without my words.  Already on the other side of security, I turned and looked back.  Tears flowing, we waved at each other one last time.  Then I turned and walked toward the future, a future that will be richer because of my life in Romania and the people I have known there.

Radio Days

Last Saturday PE and I had dinner with our friend Irina and her son.  When the dishes were put away and our friends had gone, PE and I sat on the couch and watched the old Woody Allen movie, Radio Days.  

The years of live radio comedy, drama, and shows were gone even when I was a young child, supplanted by television and much later the Internet.  Nevertheless, radio and music have occupied an important role in my life, making up the soundtrack, the music and sounds that I associate with the times and events that make up that life.

It's the early 1960s.  I lie on a blanket at Lake Welch with my sisters in New York's Harriman State Park.  The Sun shines brightly in a cloudless sky.  The sand is hot to the touch as the cool sounds of bathers splashing in the lake wash over us.  My sister's 6-transistor radio is on, and Kyu Sakamoto is singing Sukiyaki.  Forevermore, Kyu Sakamoto and Sukiyaki are linked to that day in my memory.  I have but to hear the first notes of that song, and I am transported back to that childhood day.

I can never think of the letters C, K, L, and W as anything other than CKLW, the AM radio station from Detroit that was the backdrop of summers spent with my cousins, aunt, and uncle in Michigan in the 1960s and 70s.  Evenings on the front porch in the days before air conditioning and my cousin talking of "her Tigers" come flooding back.  I feel the humidity and heat of those distant summers.

For all that my career has been associated with technology, I like to hold on to those things that were good and that link me to my past.  I have a turntable and a small vinyl LP collection.  A rotary black desk phone sits next to my computer, and a rotary princess telephone like the ones my sisters had in those 1960s of long ago adorns the table next to my couch.  It brings back memories of the Telephone Hour from Bye Bye Birdie.  The feeling of holding that phone in my lap and dialing the number of a friend feels somehow more substantial than the same call made from the BlackBerry in my purse.

Radio has also provided the soundtrack of my transition.  In August 2010 I drove from Washington, DC, to Maine, all but certain that the secret of my life was becoming common knowledge and that my State Department career would soon be over.  (See Pacing the Cage.)  I had been a listener of WAMU radio at 88.5 on the FM dial in Washington, DC, for at least twenty years and had the car radio tuned to that frequency.  The signal began to fade somewhere around the Delaware Memorial Bridge, overcome by interference from a stronger station. A few miles into New Jersey, the impinging signal overwhelmed WAMU altogether with "the quiet sounds of Sleepy Hollow."  I have been a regular listener and member of WXPN from Philadelphia ever since.  Sleepy Hollow  is my favorite listening for Saturdays and Sundays, followed closely by The Folk Show and World Cafe.  The sounds of WXPN have been with me through my first winter of angst in Romania, my 2011 summer of expectation, and my 2012 year of dreams coming true.  It was my bedside listening as I recovered from surgery in Thailand this year.

In that same summer of 2010, I fell in love with another radio show, Down Memory Lane with Toby Leboutillier on MPBN in my home state of Maine.  I was driving from Bangor to Lincoln on a Friday afternoon when I first heard it.  An "oldies" show?  Well yes, but it's not your usual replaying of the standard hits of years past.  Each week the two hour show reacquaints us with the new songs that appeared on the charts this week in ten year increments beginning 100 years ago.  The magic of the show is that Toby Leboutillier is playing songs that might have appeared on the charts for only a week or two.  Many a time I have heard a song from 1962 or 1963 that makes me stop short in the realization that I had not heard the song in fifty years.  Once again, a simple sound transports me back to a childhood memory.

There are other stations and streams.  The sounds of Folk Alley can be heard frequently in my apartment.  Bucharest's SMART FM wakes me each morning.  Sometimes I need to listen to Radio Shanson or another Russian language station to reconnect with memories of my time in Russia.

I think we all associate music with a time and place, but I think Foreign Service Officers may form an even stronger link.  As we travel the world, it's the sounds of radio from home that transport us home.  When MPBN announced earlier this year that it would take Down Memory Lane off the air, my sadness was more than surface deep.  No longer would I hear a voice from Maine each Friday evening.  No longer would I be transported magically to my childhood by a song not heard in fifty years.  When MPBN reconsidered and announced it would continue to produce Down Memory Lane as an Internet stream, I was overjoyed to a degree greater than I would have been were I physically resident in the US.  My special link with Maine was preserved.

Radio Days.  It's not just an old Woody Allen movie.  It's the musical fabric of my life that weaves sound with memory and feeling.  A year from now when I am far away from Bucharest, I will be waiting for that sound that transports me back to the memories and people here who have been so much a part of my life's journey.

Back in the Saddle

I am back in the saddle in Bucharest.  Thailand is a still fresh but increasingly distant memory.  Dilation, ever easier but still maddeningly time consuming, has become as much a part of my life as breathing and eating.  I have been back to work for five weeks, to my own surprise not missing a day since getting over my post-Thailand fever.

There is much to do.  There were letters and reports to write in the wake of the anti-LGBT protest at the Peasant Museum.  Then came the season of annual employee evaluation reports (EERs), so dear to the hearts of Foreign Service Officers (FSOs).  (Unlike performance appraisals in private industry, EERs are the only documents used by a blind panel in Washington to make promotion decisions each summer, and, hence, they achieve a cosmic importance in the life of an FSO.)  Pride Month is just over two months away, and planning has begun in earnest.  In both work and personal life, I am back in the saddle.

I am also back in the saddle in a literal sense.  Dr. Kunaporn stipulated three months as the time frame before I should be riding a bicycle again.  I took that time frame seriously, sort of.  Although Dr. Sanguan is the expert on gender confirmation surgery (GCS) and recovery from said surgery, I posit that I know a bit more about riding a bicycle than he does.  Throughout my life, I have had to field warnings and expressions of dire concern from friends and colleagues who cannot fathom the reality of my life in which the bicycle is my main form of transportation.  Thus I took Dr. Kunaporn's instruction as a guideline only, as sincerely expressed as the warnings of friends who do not understand that I have ridden my bicycle in traffic for as many years as they have driven their cars.  I would make my own decision on when to return to the bicycle, listening and looking to my own body for instruction.

I first tried to ride my Rivendell Atlantis a month ago, shortly after returning from Thailand.  This was an indoor ride on rollers, and I lasted for only 30 seconds, if that.  The message from my new anatomy was very clear.  "Don't even think of it," my soft parts yelled.

I tried again indoors three weeks ago.  Based on the experience of my earlier attempt, I covered my Brooks leather B-17S Ladies Standard saddle with two layers of foam rubber and a layer of bubble wrap.  I road indoors on the rollers for some twenty minutes, only to regret my determination afterward.  My soft parts had tolerated the ride but had become inflamed and swollen from the pressure of being pressed against the saddle.  A second attempt the next day after lowering and adjusting the angle of the saddle did not give a much better result.  I abandoned further attempts and turned instead to research.

In the days following, I learned that I was not the only woman to experience bicycle discomfort.  As much as I love my bicycle, the industry has catered primarily to men, not thinking much if at all about female proportions and differences in anatomy.  Before long, I came to Terry Bicycles, The Original Women's Bicycling Company (www.terrybicycles.com).  I ordered a Butterfly Cromoly Gel saddle and waited anxiously for it to arrive.  Unlike my Brooks, the Terry saddle has a long open slit in the center of the saddle designed to relieve pressure on a woman's soft parts, in particular her labia, urethra, and clitoris.



The Terry saddle arrived in less than a week.  I mounted it and tried a twenty minute ride that Friday evening. I then rested and mounted the bike for another twenty minutes.  Even after careful inspection the next morning with a mirror, I saw no reddening, no swelling, nothing indicating that I should stop riding.

Bicycle Protest, April 23

With Alexandra at the Bicycle Protest

It was then Saturday morning, time to try my first ride on the road since before Thailand.  I had no big plans, just a short ride to find out if I could ride at all.  Then my friend Alexandra called.  "Robyn, there's a bicycle protest today.  Can you come?"  A couple of hours later, I found myself among more bicyclists than I had known existed in Bucharest.  There were at least a thousand, perhaps two, who had gathered for a sanctioned protest of Bucharest city government plans to expand the system of bicycle lanes on sidewalks.  These were clearly my type of people, bicyclists who know that their place is on the road with traffic.  We road together slowly for more than an hour, stopping in front of the city government to blow our whistles, sound our horns, and yell as loudly as we could.  This slow group ride was the best possible test of my new Terry saddle, as it forced me to stay forward and in the drops so as to keep my hands near the break levers.  If there was any ride that would cause my soft parts to scream, this was it.  They stayed silent the entire time, and a close inspection by mirror that evening showed they had slept through the entire experience.

Riding the Rollers

No, I was not ready to hop on the bicycle and resume daily commuting that Monday.  My legs, heart, and lungs had paid a price for my being largely sedentary for three months.  Instead, I road the rollers each evening, coaxing myself back slowly.

The Bucharest weather cooperated in keeping me indoors.  A surprise spring storm dropped six inches of snow on the city on Tuesday.  While others grimaced at the sudden return to winter conditions, I smiled to see the snow.  The Embassy opened two hours late.  I stayed indoors with my coffee, admiring and loving the view of the continuing snowfall.  I had missed most of winter by going to Thailand, but winter had saved itself to give me one last display.  I could not resist the urge to go outside and play in it, even attempting a snow man that ended up more like a snow pomegranate.  It was wonderfully beautiful, and a tear fell, the first of many in the months to come, as I thought that this will be the last snow that I see in Romania.

My Snow Pomegranate

The snow melted, I headed out on the road this Easter Sunday, riding in the direction of the Embassy and back.  The time has come.  Tomorrow I will resume my normal life, riding by bicycle to and from work as I have most of my life.

I am back in the saddle in Bucharest on this last day of March, making every minute of every day count, holding on but preparing for the changes that I know this spring will bring.

Home Sweet Home in Romania -- or -- The Exclamation Point (Conclusion)

Time lost meaning for us in Thailand.  In the fog of surgery, anesthesia, morphine drips, and surgery again, OD and I quickly forgot about days of the week and even how long it had been since we left Romania.  When our release day came on February 7, it took us by surprise.  Only once back at the Aspasia Resort did time again begin to take on meaning.  There was the necessity of dilating three times per day along with the need and desire to be up in time to walk, donut cushions in hand, to the Aspasia's outdoor restaurant for the morning breakfast.  Still, when the time came to depart Thailand on February 19, we were almost as surprised as we had been on the day of our hospital release.  It was time to go home, to begin the process of returning to work and normal life.

Final Dinner in Phuket

Phuket to Bangkok and then Bangkok to Amsterdam.  Business class may have been a luxury on the way to Thailand, but it was our salvation on the return, the thought of an economy seat almost as painful as the thought of sitting on a bench without our donut cushions.  Our route took us directly over Samarkand, bringing with it good memories of my last visit there with my son in the winter of 2009-10.

Amsterdam to Bucharest, OD and I were beginning to go through the emotions of parting.  How could it be that we were about to go our separate ways after supporting each other through one of the most significant life events any human can experience?  Through customs at Otopeni Airport just after midnight, a group of our friends stood waiting with hugs and flowers.  From there it was off to the airport hotel for OD, who had one short flight remaining the next day to take her home to Moldova.  For me it was a twenty minute ride to my home in downtown Bucharest, where friends.had made my bed with clean sheets and seen to it that I had enough cooked food for my first days back.

I was not up until after noon on the 20th as the reality of the calendar returned.  February is LGBT History Month in Romania, and the LGBT rights organization ACCEPT had scheduled a film showing that evening in the auditorium of the Peasant Museum, just a ten minute walk from my home.  I decided to go, as I knew I would find many friends there.  Since the film was to be shown with U.S. Embassy sponsorship, I knew I would find Embassy friends there as well.  

What I didn't know was that a group of anti-LGBT activists planned to disrupt the event.  Just before the film was to begin, some 50-60 protesters filed into the auditorium, outnumbering the film-goers.  Within minutes of the film's start, they had blocked the projector's light path and had unfurled Romanian flags and banners as they began singing the national anthem and other patriotic songs interspersed with homophobic epithets.  They shouted "Shame!" and "You are not Romanians!"  The police were called but declined to intervene in the auditorium.  The film-goers eventually abandoned the hall, leaving it in the hands of the protesters.  Fortunately, the protest was limited to words, not blows, and we all left without harm.  

Video of the Peasant Museum Protest

The fog of Thailand dispersed entirely as the reality of life in Romania returned.  As welcoming as this country has been to me, there is a dark side in the form of people and groups who oppose LGBT rights and are willing to be vocal about it.  Late last year, a young LGBT activist was hospitalized after he and other volunteers were attacked by hooded men following an LGBT event at a local university.

If there is a silver lining to the night at the Peasant Museum, it is that the protesters may have won the battle but appear to have lost the war.  Most press accounts came out against the protesters.  I'm proud to say that the U.S. Embassy responded strongly with a public statement and an op-ed in support of LGBT rights and decrying the Peasant Museum protest.

My Welcome Home Evening with Friends

The next morning I woke to the uneasy feeling that I may have caught cold.  By Friday I knew I had a fever.  Embassy friends had organized a welcome home party for me that evening, and I almost didn't go, warning the hostesses that I might infect everyone.  Feverish, I went by taxi and stayed one hour, bathed in the love of friends who had come that night with flowers and hugs.  By the time I got home, my fever was 103F (39.4C).  I collapsed on the couch.  Only several hours later did I have enough strength to undress and drag myself to bed.  I was in far worse misery than I had been at any time in Thailand, apparently the victim of something that had found its way to me on the flights home from Phuket.

My Bucharest friends rallied to me on Saturday and nursed me back over the next several days.  All hope of returning to work on Monday was gone, but surprise of surprises, the fever finally broke without any follow-on cold or flu symptoms.  I returned to work for the first time on Wednesday, February 27.

My recovery from my various surgeries continues rapidly forward.  I'm constantly tired from the necessity of being up before 5am to do my morning dilation.  I have no lunch hour as I now use that hour for dilation in a room set aside for me at the Embassy.  By the time I've done my evening dilation and had dinner, it's nearing 10pm.  The good news of dilation is that I have already said goodbye to Lyolik, Johnny Angel, and Dimchik (Nos. 1-3).  I begin now with Good Neighbor Sam (No. 4) and move up from there.  (See Vodka Without Beer.)

Exercise is a problem.  It will be some time before I can return to bicycle commuting, and I now depend on friends for rides to and from work.  Since there is no workout room where I live, my only exercise is stair walking.  When I get home in the evening, I put on my exercise outfit and climb the stairs of my five-storey building fifteen times.  I've tried riding my bicycle indoors on rollers just to see if I can, but even with additional padding over my leather saddle, my soft parts let me know they are not yet ready.  I have hopes for a split saddle that I've ordered from Terry Bicycles that will leave my clitoris and urethra free from saddle pressure.

Weight is also a problem.  With little exercise since mid-January, I've gone from 62 to 65kg.  I've made some dietary adjustments that I hope to maintain even after returning to my daily bicycle regimen, but at this point my hope is only to stop the weight gain, not reverse it.  I miss my bicycle and the independence and weight control that it gives me.

Other than for weight gain and obligatory dilation, life is returning to normal with its cycle of work and friends.  I look in the mirror both marveling and in wonder.  "Could I ever have looked different from the way I do today?"  I know the answer is yes, but the emotional answer is no.

Home sweet home.  I am home in Romania, in the circle of friends who have seen me through the greatest transformation of my life.  The exclamation point now stands proudly at the end of a long sentence that has been my life so far.  To all who helped me put it there, you have my deepest thanks and more.  May the luck of the Irish be with you on this St. Patrick's Day and every day of your lives.

* * * * * * * * * * * *

Follow these links for more of The Exclamation Point:: 

Previous entry -- My Own General Contractor

My Own General Contractor -- or -- The Exclamation Point (Part 15)

Extreme discomfort.  Not really pain, but I am not well.  I can't see.  My eyes are swollen shut, and I sense that my face is heavily bandaged.  My back aches.  Some device seems to be compressing my legs at regular intervals, perhaps to keep the blood circulating?  My throat is as dry as sand, but I moan a rasping question, "What time is it?"  Someone answers that it's 11pm.  I remember being wheeled to the operating room at noon.  The same voice tells me that I will be kept in the intensive care unit (ICU) for the night.  I moan for water and am given a small drink through a straw.  I then moaned one phrase over and over again:  "OD.  Tell OD I'm here."  No one replied.  Perhaps the ICU staff thought I was delirious? 

This is my report card for the Phuket International Aesthetic Center (PIAC), the Phuket International Hospital (PIH), their surgeons, and their staff.  The title of this post gives the hint of what the grade will be.  At PIAC, you are your own general contractor.  During my long night in the ICU after 9-10 hours of surgery made up of 2nd stage gender confirmation surgery (GCS) followed by 1st phase facial feminization surgery (FFS), I had ample time to ponder whether I was qualified to be the general contractor behind my own surgical fate.

What do I mean when I say that at PIAC you are your own general contractor?  Quite simply, you, the patient, are the one in charge of your treatment.  You are in the driver's seat, the one who makes the decisions of what surgical procedures to undergo, the one who decides how much discomfort can be endured.   It is a very American trait to want to be in control of the buying process in any major purchase, but in the case of major surgery, should I be the one in charge, the general contractor who makes the major decisions?  I'm not sure.

I think back to a year ago when I first corresponded with PIAC.  One aspect of the correspondence that immediately appealed to me was that Dr. Sanguan Kunaporn, the surgeon for gender confirmation surgery (GCS), corresponded with me directly before turning me over to his administrative office.  I noted early on that I was considering some degree of facial feminization surgery (FFS) in parallel with GCS, to which Dr. Kunaporn replied, "Yes, if the FFS is not really very extensive and you have approx. 1 month time in Phuket, I have no objection."  He then put me in touch with the Dr. Rushapol Sdawat, the craniofacial surgeon who performs FFS at PIAC.  In the following weeks based on photos that I provided, we decided on several facial procedures that would be beneficial.  After that, it was a matter of waiting.

A driver and one of PIAC's international coordinators met us at the airport in Phuket on January 20 and took us to our hotel, the Aspasia Resort in Kata Beach.  Two days later we reported to PIH.  OD was admitted that day, and I was admitted the next.  The admission procedures were straightforward and efficient.  After admission, we were taken to the PIAC office, where one of the English-language coordinators welcomed us before sending us on our way with a technician who took us first for an X-ray and then to our room.  Up to that point, our PIAC experience rated an A grade.

Our first qualms started when we were in our room.  The nurses and assistants, every one of whom we came to love, spoke only the most limited English.  Even ordering OD's first meal was not easy.  With time we came to joke over thrice daily ordeal of ordering meals.  "Hot green tea" and "guava juice," both of them listed in the menu, caused consternation, as though they were ordering exotic beverages from Mars.  With time we would point at OD and say over and over again "hot green tea."  Then we would point at me and say "guava juice with ice."  These became mantras.  By the time we left the hospital, we had concluded that OD should begin teaching the staff English, as her very limited English was generally better than that of much of the nursing and support staff.

If we had trouble ordering meals, just try to imagine the difficulty we had with medical issues.  I will never forget the night when I had a splitting headache that would not let me sleep.  I pressed the call button more than once, and the assistant on duty came immediately each time but seemed unable to understand that I wanted something for a headache.  In exasperation, I finally got up and walked to the nursing station.  There was an empty chair.  I sat in it, put my head on the desk, pointed at my head, and repeated again and again, "Headache."  Finally one of the senior nurses heard and understood.  I got my Tylenol.  

Thus my overall grade for the nursing and support staff is B-.  That's made up of a C- for English ability and an A for caring once they could be made to understand.

Dr. Sanguan Kunaporn

What about the surgeons?  Both Drs. Sanguan and Rushapol get an A- or A in my book for technical expertise.  In transgender circles, Dr. Sanguan is the better known of the two.  He is professional and caring, no doubt about it, but he is also busy.  We first met him in person on the night of OD's admission, and we did not see him again until the next night, the eve of OD's first-stage GCS.  Our direct contact with him was at all times limited to what was necessary:  the operating room, brief post-op checkups, dilation instruction, and suture removal.  That said, he was always ready to answer our questions.  We just had to remember to have them ready to ask during those brief windows of direct contact.  He gets an A for bedside manner and a B for availability.

With Dr. Rushapol Sdawat, Two Weeks after FFS

I knew less about Dr. Rushapol before going to Phuket, but by the time we left, I felt I knew him better than Dr. Sanguan.  First there were the pre-surgery photo sessions and discussions of what procedures to do, what procedures to leave out.  I've already noted in my previous post that Dr. Rushapol fed me personally, spoonful by spoonful, in the ICU on the morning after the first phase of my facial surgery.  I saw more of him in the days and weeks following surgery than I did Dr. Sanguan.  I will never forget his caring, gentle, and soothing voice.  He gets and A for technique, an A+ for bedside manner, and an A- for availability.

Although I did not know it before we arrived in Phuket, I was indeed my own general contractor at PIAC.  I had naively expected that Drs. Sanguan and Rushapol had discussed between themselves the extent of my surgeries and what was reasonable.  In retrospect, I imagine that if such a conversation took place, it was of short duration.  There was no one at PIAC to serve the function of patient advocate.  I say that even though I came to love the young women who work there as international coordinators.  It's not the same thing.  There is no one to sit with the patient and review the overall treatment plan, expected results, and recovery timeline.

I had ample time while bandaged and with limited sight to recall  that what I was encountering in Thailand was not necessarily that different from what I would have encountered in the US.  I thought back to an earlier time in my life when my sister-in-law landed in the ICU at a hospital in Maryland.  She was there for months.  It did not take many weeks for us to realize that there was no one "in charge."  Many different specialists came and went, but no one seemed to have the high ground with the overall view of my sister-in-law's treatment.  My ex-spouse rose to the challenge.  She became the greatest and best patient advocate I have ever known, cracking the whip over nurses and doctors alike.  She became an expert on the hospital structure and organization and learned how to work through it to get the best possible treatment for her sister.  She became the general contractor who organized the work of doctors and staff.  THAT is what is missing at PIAC.

As we came to grips with this fact, OD and I did the best we could to be advocates for each other.  I would not recommend that anyone go by themselves for GCS or FFS anywhere in the world.  OD and I had each other, commiserating in discomfort, keeping up each other's spirits, and laughing when we could.

Should I as general contractor have ordered such extensive surgery in such a short period of time?  In retrospect, I would say the answer is NO.  Three major surgeries, twenty-four hours of general anesthesia, and days of morphine are a heavy load for the human body to bear.  If I had known six months ago what I know today, the rational side of my brain might well have decided that GCS and FFS should be done separately with perhaps a year in-between.

When we were released from PIH, OD and I returned to the Aspasia Resort.  My face was black and blue, still with bandages in many places.  I attracted stares from everyone and quickly came just to nod my head yes when people would ask if I had been in a motorcycle accident.  I had lost all feeling and motion in my left foot during the long 2nd stage GCS and 1st phase FFS surgery, a classic case of drop foot likely caused by a pinched nerve from being in a gynecological position for so long.  

Working Out at the Aspasia

Despite this, within days I was doing light workouts on the elliptical machine in the resort's workout room.  In the evenings I would walk down to Kata Beach and walk from one end to the other and back.  As general contractor, I had decided that my recovery should be as active as my condition and energy level would allow.  I might have been capable of only a third of the physical activity I had been used to prior to surgery, but a third is not zero.  With each day I could feel myself get stronger.  The memories of my night in the ICU began to fade.

One Day Before Returning to Bucharest

Now back in Bucharest some six weeks after my 1st stage GCS, I am well on the path to full recovery.  All the scars and bruises on my face have disappeared, and the swellings are diminishing.  Dilation goes well three times per day, and I can now sit in most any chair without using a donut cushion.  In fact, I briefly road my bicycle on rollers today for the first time since before surgery.  Perhaps in another 1-2 months I will be able to ride it for longer intervals and return to the road?

So from the perspective of today, I am glad that I said YES to all the surgeries six months ago.  Even if this general contractor should have paused before ordering so much surgery, today she is glad she did it all.  It is over and done, and I can move on with my life.

It is premature for me to give a final grade to PIAC and my GCS/FFS experience, but as of today, I would say the overall grade is a healthy B+.  (Kata Beach gets an A+ as a wonderful location for initial recovery.)  To anyone else thinking of PIAC for GCS and FFS, I would just say do your research and evaluate your own physical condition and what you can endure in a short period.  If you are comfortable being your own general contractor, PIAC could be the right choice for you.

Final Sunset from Kata Beach

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My Million Baht Body -- or -- The Exclamation Point (Part 14)

So what did I have done in Phuket, and how much did it cost?

Until now I have written only in general terms, so let me  get specific for anyone who may be considering surgery through the Phuket International Aesthetic Center (PIAC) at the Phuket International Hospital (PIH).  (Note:  Dr. Sanguan Kunaporn has his own site in addition to the PIAC site at phuket-plasticsurgery.com.)

Gender confirmation surgery (GCS) with Dr. Sanguan Kunaporn cost $11,000 USD.  I prepaid this fee directly to Dr. Sanguan's account both for OD and for myself.  There is an additional $2000 charge if an extra skin graft is required.  As it turned out, one of us did require the extra graft -- I won't disclose whether it was was me or OD -- this graft being taken from the top of the leg.  We paid the extra cost by credit card on the spot.

Breast augmentation (BA) with Dr. Sanguan was $4000 USD done in conjunction with GCS.  Both OD and I had been uncertain about BA before going to Phuket and made the decision only after we were in the hospital.  We paid for this also by credit card.  Of all the surgeries we underwent, it is BA that provides the nearest thing to instant gratification.  Prior to BA, I was not quite a 36B/38B.  After 250ml implants, I am a full C cup.

Then we come to facial feminization surgery (FFS).  OD, lucky girl, had no need for FFS of any kind, but yours truly knew she could benefit from some degree of FFS.  The question from the beginning was, how much?  The FFS surgeon at PIAC is Dr. Rushapol Sdawat, to whom I sent a series of photos some six months before surgery and from whom I received a number of recommendations.  After meeting me in person in Phuket and after looking at photos of my sisters, Dr. Rushapol modified his recommendations, in particular dropping his earlier recommendation for a chin implant.  The guiding principle was that I needed to come through FFS with it still being evident that my sisters and I are from the same family of Scotch-Irish heritage.  This is the final list of procedures that we agreed upon along with prices in Thai Baht --

• Forehead lift -- 215,000
• Lower face and neck lift -- 200,000
• Lower blepharoplasty -- 28,000
• Reduction rhinoplasty -- 150,000

Thus the total fee to Dr. Rushapol was 593,000 Thai Baht,  approximately $19,900 USD.  I was not the first person to learn on this journey that FFS is generally more expensive than GCS.  I had transferred more than this in advance to the PIAC account used by Dr. Rushapol, and PIAC was very professional about refunding the overpayment.  (Note that payments to Drs. Sanguan and Rushapol go to separate accounts.)

FFS was the greatest gamble in all the surgeries I underwent in that one does not truly see the results until two, three, or more months after surgery.  As I write, my face is still swollen, a work in progress to be evaluated come summer.  All I can say at present is that I see good movement in the right direction since the days immediately after my surgeries.  

I can also say that I felt myself in good hands with Dr. Rushapol, who was both professional and gentle at all times.  I will never forget how he stood by my bed in the intensive care unit and personally fed me my first post-surgery meal the way a mother would feed a child, mouthful by mouthful.  Bandaged and without sight, I could not feed myself.  Although Dr. Rushapol could have called for a nurse, he took the time to do this himself, speaking soothing words about the results of the surgery that he could see but that I could not.

I will write separately about the care and service at PIAC.  In fact, I will have quite a bit to say, most of it positive but with a view to giving others advance information based on our personal experiences.  I will also give some hindsight consideration to the question of whether I should have undertaken quite so much surgery in such a short period.

First Post-FFS Day with Makeup

At the moment, however, I am remembering my last day at the PIAC office when we went over the final financial accounting.  Kat, one of PIAC's coordinators for international patients, took me through the paperwork line by line.  When she got to the last page, she paused.  She looked up and said, a bit in awe, "You spent over a million Thai Baht!"  

For those who prefer USD, I spent in the vicinity of $35,000-37,000 USD for all surgical procedures.  As to total trip cost, add $3160 USD each for round-trip business class tickets from Bucharest to Phuket and $1925 USD for our two days at the Aspasia resort before our surgeries and another twelve days after our release from PIH.

I am now recovering slowly at home in Bucharest.  I had intended to return to work tomorrow, but instead, I was felled by a virus that must have found its way into my system during our nearly 24 hours of flights from Thailand back to Romania.  Two days ago I was running a temperature as high as 103F (39.4C), and only today do I feel I have rounded a bend as the fever has dropped and remained below 100F.  My return to work will be delayed a few days more.  I am beginning to learn what others have learned before me, that recovery from this amount of major surgery will require time and patience.  

No longer feverish, I think back on Kat in the PIAC office and look at myself in the mirror.  I like what I see even with much of my face still swollen.  I am now the proud possessor of a Million Baht Body.

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Vodka without Beer? -- or -- The Exclamation Point (Part 13)

Although written to be mildly humorous, this entry describes a medical procedure that is the centerpiece of recovery for anyone who has undergone gender confirmation surgery (GCS).  Those not wishing to read about such personal medical procedures are advised to look elsewhere and catch up with this journal at another time.  Meanwhile, OD and I are rather busy, as you will discover below.

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I first heard the Russian expression водка без пива, это деньги на ветер (vodka without beer is throwing money to the wind) from my Petersburg friends Zh and V in 2005.  I'm sure the expression has been around forever, but like anyone who attempts to master a foreign language as an adult, I am continually picking up new expressions that were not in textbooks and dictionaries when I was a university student in the pre-Internet days of the 1970s.

One might debate the wisdom of the aforementioned Russian expression, but OD and I have our own variation that applies as one of the certainties of life for anyone walking our path:  GCS without dilation is throwing money to the wind.

For those who have walked this path already, I apologize for a digression into known territory where OD and I are still beginners.  For those who have no clue as to where I am leading, I will attempt to enlighten.

You see, what Dr. Sanguan has done for us is to create neo-vaginas.   Two weeks post-surgery, I look in the mirror and marvel at how normal I appear even this soon.   To our bodies, however, our neo-vaginas are wounds that should be closed up and healed over.  To prevent this, to adapt our bodies to the new normal, we must dilate.  For the first three months, we most do so three times per day, morning, noon, and night.  Dilation is, in fact, the centerpiece around which we must arrange our days.

Dr. Sanguan visits his patients the day after the second surgery in his 2-step GCS procedure.  He comes bearing gifts in the form of six plexiglass stents that bear a somewhat clinical resemblance to a particular part of the male anatomy.  Whereas a woman might see a man for the first time and wonder about the size of this anatomical feature hidden inside slacks or shorts, OD and I were left in no doubt about our new friends.  Lengths are clearly marked, ruler-fashion, in inches, and diameters are recorded to the nearest 1/16 of an inch.  Our reaction to Dr. Sanguan's gift would be familiar to any teenage girl, a combination of fear, anticipation, and an urge to exclaim, "You must be kidding; you want me to put that . . . in here?!"

Our Insatiable Gentlemen

The stents are marked clearly as Nos. 1 through 6, but OD and I decided to personify them with human names.  This being a bilingual pilgrimage to Thailand, we have, of course, chosen appropriately from both English and Russian.  

No. 1 is Lyolik – nice, gentle Lyolik.  He is small and shy and slow to take advantage of the situation.  He must be coaxed inside and coaxed further still to go the distance.

No. 2 is Johny Angel, who is nice and gentle but without the shyness of Lyolik.  Just think of OD and me as Shelley Fabares wannabes.

Johny is followed by Dimchik and then Good Neighbor Sam, that family man from 1960s suburbia who steps in to assist his neighbor in a time of need.  Vasya then marks a transition to a qualitatively and quantitatively different dimension.

Finally we come to No. 6.  Here OD and I come to a certain parting of the ways.  For OD, No. 6 comes from deep in Russian history with a name that inspires a certain degree of dread.  I, on the other hand, felt I needed to end on an American note.  I have chosen from U.S. political history a figure whose title implies the respect with which I approach No. 6.  With this mixture of dread and respect, OD and I hold our last gentleman inside for somewhere between five and ten minutes.

So that, dear readers, is how we spend much of our day while in recovery at the Aspasia Resort in Kata Beach, Phuket, Thailand.   Between preparation and cleanup, each daily session with our gentlemen friends takes on the order of 45 minutes.  We can already see that our days for the next three months will center around these thrice daily trysts.  Neither of us is looking forward to our first session after our return to Romania and Moldova.  For nearly 24 hours of travel time, we do not expect to be able to arrange even a furtive meeting.

Speaking of our return to Europe, we fly home from Phuket in two days.  If there has been a casualty in our journey to Thailand, it has been my writing.  Forgive me for my conceit of believing I would be able to write frequently, giving near daily updates on our status.   In this I was sadly mistaken.  Recovery from GCS, in my case combined with facial feminization surgery (FFS) and breast augmentation (BA), takes time, strength, and patience.  I will fill in the blanks retrospectively from my home in Bucharest.

Meanwhile, our six insatiable and implacable gentlemen are calling.  Our day is planned.  We are working hard to prevent our money from blowing away in the wind.

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