My last entry before the operation, titled “My Montréal Pre-Op Regime”, was posted a few days before I went to the clinic. I filled those days with wonderfully stimulating activities such as dancing with Contact Improvisation groups and attending a feminist performance festival. On Sunday I made a trip to the Old Port of Montréal to find the dock where I had disembarked in 1959 from a steamship as an immigrant child of three years old, with my mother and little brother. It was an emotional recognition of another transition.
Terry was sweet, and stayed, chatting until the car finally arrived 40 minutes later. In a rush, I said goodbye to my lovely home on Rue St. Zotique, hid the key in a flowerpot on the front stoop, hugged Terry, and was sped off in the back seat of the powerful black car. Years of imagining and deciding, months of financial commitment and final preparations, weeks of travel, and finally I was in the care of the Clinic. I felt very alone.
The driver unloaded my suitcase, and zoomed off leaving me standing on the driveway of a huge house with a stone façade and plastic on the sides, a pastiche of castle and Swiss chalet. The door was locked, but soon Eveline came and let me into a large, spotless entrance room with antique furniture and fake marble tiles. There was some confusion as she had my name as Angela, which is my middle name. She gave me my keys. Before showing me my room, she gave me an enema kit and told me I had to use it at 4 pm the following day.
My room was the third floor attic suite. It was accessed by an ornate steel spiral staircase from an atrium on the second floor at the back of the house. Overwhelmed, I tried to relax in my room with its en suite bathroom, dormer windows and glass patio doors opening onto a little balcony over the atrium. The slanting ceilings made the architecture more interesting. I was apprehensive of the bed with it’s ranks of ruffled pillows, but it was comfortable. Despite the decorative shelves suitable for a palace and jewelled toilet brushes in the bathroom, the toilet paper was industrial single-ply. The coffee bar nestled among the antique furniture in the atrium had a little fridge, and some fancy herbal tea, but no black tea. Only a semblance of a palace. I had brought the last of my teabags and my thermos, and there was enough milk in the fridge, so I was relieved to know I could have my customary tea on the following morning.
The island appeared to be owned by the Catholic Church. The buildings were overseas missionary headquarters and seniors’ residences. The end of one of the buildings had five floors of steel balconies connected by stairs, caged in with steel mesh. On the second floor and on the fourth floor balconies an old man and an old woman paced slowly back and forth, oblivious of each other, and of me.
Later Monday afternoon, waiting for supper, I met the other girls awaiting surgery. There was Renée, a beautiful, tall woman with long blond hair in her 30s, from Wisconsin. She used to be the lead singer in a rock band. Despite her name, she was not French. There was Donna, in her early 50s, living in Ontario, but working in the tar sands of Alberta. Her face was pleasant but a little weathered. She explained that the barely visible scars were from a mine which blew up her armoured troop carrier while she was in the army in Serbia. She had served for 32 years. She was talkative and opinionated. Kayley was 22, blond and beautiful like Renée but not as tall, polite, here with her mother, Nancy. They had driven from Ontario.
Over supper I learned more about them. Kayley wants to be an aesthetician or a plastic surgery nurse. She’s already had a breast enhancement, but despite having voluptuous D-cup breasts, she’s planning another surgery to make them bigger. Donna noted down the name of Kayley’s surgeon for her own breast augmentation which she plans to do as soon as she saves enough money. Her breasts appeared to be a nice C-cup. I didn’t join the talk about breasts. I don’t like the idea of implants. I’ve grown to accept that mine will never get to the size of even an A-cup. I began taking estrogen for other reasons, but I was thrilled when my breasts began to grow. I think it’s one of the most magical things about this process, feeling the chest growing mammary glands and putting on fat.
Kayley’s mom, Nancy, worries about everything; her car, which is stalling, finding her way in Montreal, her daughter’s operation and hair extensions. There was much talk about hair, and finesteride, the anti-androgen Renée is taking, reputed to reverse male pattern baldness, though neither Donna nor Kayley have male pattern baldness. They all talked a lot and occasionally asked me questions but didn’t wait for my reply. They admired my hair, how it’s so thick. When I tried to tell them my hippie secret, that I don’t wash it, they didn’t seem to hear me.
After supper Renée, whose surgery was scheduled for Tuesday morning, was picked up to go to the hospital. The rest of us gathered in the atrium and sat up talking. Donna considered the $2,200/month pension she’ll get from her army days to be not sufficient to support her lifestyle, even after having paid off her condo. Kayley worried that a $40,000 a year job is not respectable, though she lives at home. I tried to explain to them how I’ve learned to live on $12,000 a year. Nancy was from a military family, like Donna, and so we talked about army life. We also talked about sex after surgery. Kayley said her boyfriend was anxious to get down to business as soon after surgery as possible. Donna told us tales of dating in the tarsands community, her strategies for avoiding sex with the men she went out with, and how a transwoman friend was “wearing out her new vagina before the warranty expired”. I was tired, and feeling anxious, so I went to bed at 10pm. They are nice people, and I enjoyed their company, but I felt so unlike them. Was this the tribe I was going to be part of? Did I want to? Was I falling for gender binary stereotypes? Was I being scammed by a consumer culture trap? My doubts were not as specific as this. I lay in my opulent bed. For the first time I felt an awful sense of fear at the enormity of what I was doing.
In the morning I enjoyed my thermos of tea with milk in my large bedroom with the morning sunshine coming in the windows. I had a shower, then descended my spiral steel staircase to spend a few minutes in the atrium chatting with Donna before going down for breakfast. Somehow everything seemed nicer in the morning. I talked with our hosts, Eveline, the boss, and Guy, her quiet and helpful partner. The dining room and kitchen were in a big, open room, bright with the morning light. I looked at the paintings on the walls and realized they were originals, of Quebec landscapes, in vaguely impressionist styles. I commented on them to Eveline, who proudly pointed out a few that she had painted. Despite our differences, I was beginning to appreciate the company.
After lunch, Donna and I decided to go for a long walk together, an expedition to visit the hospital and the recovery clinic. We strolled in the winter sunshine. Donna shared one anecdote after another. I managed to tell a story or two of my own. We crossed the bridge over the north branch of the St. Laurence, past a large red brick hospital and a prison, and after three quarters of an hour we arrived at l’Asclépiade. The recovery clinic was as I had been told, a big old house next to a park on the shores of the river. I hadn’t realized the clinic had it’s own hospital, a white two-storey building next door, unimposing and reassuring in it’s smallness. I needed to pee before we began the journey back, so we went in, and I introduced myself to James, a friendly and polite man at the reception desk. I had to put on sterile booties over my boots, and used the washroom of one of the pairs of patient rooms. I found out later there were four pairs of rooms, in each corner of the first floor, with two beds in each. Upstairs was the operating theatre. In the basement was storage, and a tunnel connecting with the recovery clinic.
I found the hospital friendly and scrupulously clean, but not sterile, and felt relieved. While Donna and I were looking at the recovery clinic next door, Nancy and Kayley drove up and offered us a lift home. Nancy was anxiously figuring out the route so she could drive it later alone, when she came to visit Kayley. The day was still beautiful, so we refused their offer and walked back. At the bed and breakfast I lay down and tried to nap. I had some moments of sadness, a sort of vague nostalgia. The rest of the afternoon was occupied with my first pre-op enema, our “last supper”, and soon after the taxi arrived to take us back to the hospital.
No tea, no breakfast. By 7 I had showered with special antiseptic soap, put on the hospital gown and booties, and was waiting, hungry, to see the surgeons. We were informed the operations would begin somewhere between 8am and 12 noon, and finally I was told I would be second of the three, at around 10. I went for a walk around the hospital. Donna was already gone to the operating room, and Kayley was having a shower. I checked Facebook, and wrote a profile post. “I’m feeling calm now. Last night I had butterflies… It has been an amazing journey! I'm ready.”
The next thing I knew, I was waking up and James was asking me questions.
I felt clear headed, but disconnected, as though watching through a window. I knew where I was and I marvelled at the speed and co-ordination of the team of attendants who were bustling around me. They were disconnecting and putting away devices and instruments, in a smooth, high speed ballet. I marvelled at how good I felt, the clarity of my awareness that the surgery was over and that I was finally living the future I had dreamed about. It didn’t occur to me I was high on opiates. Soon I was wheeled to the elevator and back to my room.
“Everything went really well. I'm weak, but very happy. Thank you so much to all you wonderful friends who sent me messages, comments and encouragements. A special thank you… for the (virtual) flowers! My favourite song as a child; "White coral bells, upon a slender stalk, lilies of the valley deck my garden walk..." I feel so blessed!”
I slept between visits from the nurse, taking a few moments to stretch my feet and gently move my legs, and stretch my upper body before dozing again. I could feel the incessant squeeze and release of the leg compresses. I wore my headphones, and played music from my computer, and it helped keep me happy when I was awake and drowned out the sounds of the hospital while I slept.
I woke on Thursday morning feeling uncomfortable, groggy and nauseous. James brought me tea, which made me happier and settled my stomach, and I was able to have some breakfast. I had lost the euphoria of the previous afternoon, and realized it must be the aftereffects of the pain killers I had been given the night before. After breakfast I was cut out of another pair of disposable panties, changed and cleaned up a bit more, then I carefully hiked myself over to the side of the bed, rolled on my side, and performed the single motion swivel and stand I had been taught to get out of bed. I showed the nurse how I was able to organize the transfer of my tubes and bags to the rolling stand, and with her help I went for a little walk. It felt so good! I was able to get back into bed by myself, and after resting and napping, I was feeling much better.
Having passed the test of getting in and out of bed by myself, and dealing with my tubes and bags, I was allowed to get up when I wanted. The staff were particular with rules, and I was happy to let them make decisions for me. I got up before lunchtime to get some tea and took advantage to shuffle around the hospital and visit Donna and Kayley. Renée was gone, taken to the recovery clinic, and had been replaced as my room mate by Ryley, a hilarious trans guy. I asked him to open the curtains so I could see out, past some junipers to the street. We entertained each other with conversation and banter. It was his third operation at the hospital, his penultimate. He knew all the staff, had brought them presents of candy, and was full of schemes to get extra favours. After Ryley was taken to the operating room, I had a quiet afternoon. More sleep, more walks, internet, music.
I was in pain and I was uncomfortable. Some suggested it was because I had walked so much. They tried a new painkiller on me, Dilaudid, as I didn’t want to repeat the experience of that morning and wake up feeling like a zombie. Synthetic heroin. It took a long time to take effect, so I put on my headphones to block out the night activity and tried to relax. After the second set of pills, the pain was still bad, but I slept more. The third set of pills worked, and I slept soundly to the music of Bach on the classical guitar and woke up to the arrival of the morning nurse, with little pain and feeling rested and happy!
They removed the leg massaging sleeves in the morning and my IV in the afternoon. Ryley was feeling better, and he and the nurses realized he had been given an extra dose of morphine the previous evening by mistake. Many mutual apologies were exchanged. Ryley and I had a fun morning of animated conversation, causing the orderly to close our door after noise complaints. We went for walks. I did gentle tendus and demi-pliés in the sun by the back door. We rested. I had a lovely conversation with Louise, one of the nurses. She explained how she had come to work at the hospital and clinic, and how much she liked it. She pointed out that it was a hospital without sick people, that all the patients were there because we wanted to be, and were grateful of what the hospital was doing for us. One of the orderlies, motherly, cleaning up our room, admitted that she was a transsexual, and had had her operation at the clinic several years before.
I showered and dressed in the clothes I had prepared, a favourite pleated cotton skirt and a soft aqua cotton sweater. I did my hair and makeup, and felt wonderful, but weak. The orderly lifted my suitcase on to my bed, and I packed my pyjama and toiletries, and my computer. Then another orderly from the recovery clinic came. He took my suitcase and computer and in a while he came back with a wheelchair. He was a short, slight man by the name of Sébastien. Later I learned that he too was trans. He wheeled me across the pavement in the bright daylight, ice and snow exciting my senses, up a long ramp, and into the Asclépiade recovery home. I was welcomed by one of the nurses and given a brief tour of the downstairs. I was instructed on the use of the ice machine. Sébastien carried my suitcase up the sunny staircase to my room, and feeling a bit overwhelmed, I followed.
Kayley was in the next room, with Renée, who later confided to me that Kayley would have preferred to be with Donna, with whom she had shared a room in the hospital. When Donna came, I offered to switch if she wanted, so she and Kayley could be together, but she said she’d prefer to stay with me. So us older ladies shared one room and the “girls” another. After a few days, Renée, suffering from complications, got tired of Kayley’s complaining, drama, and particularly her incessant, loud cellphone conversations and arguments with her boyfriend. She was moved to a room of her own that opened up when one of the men left.
We were all in a wing of the house, on a lower level than the main house, connected with a sunny atrium where the main staircase descended to the long glassed in porch, and a short set of steps which led to the upper level of the main house, where the other patients had rooms. Those rooms were private, but they had shared bathrooms off the common hall. One bathroom was large, and had an examining table with stirrups in the corner.
That evening after supper I had visitors; Terry and her beautiful androgynous young friend, Emmanuelle. Nightingale also had visitors, and it turned out they were acquainted through the Montréal transgender community, so we all sat together in the porch. I began to feel tired, but stayed on because I was enjoying the company. I overdid it, and had a difficult night, needing Dilaudid in order to sleep.
Saturday I walked less and napped and surfed the internet. I finally had a response from my sister, and we had a long conversation on Skype. Donna was happy for me, knowing that I had been fretting about feeling neglected. Nightingale, not feeling well after having her dressings removed, in discomfort from her stint (the packing inside her vagina) stayed in her room. Knowing I was interested in politics, she sent me a Facebook notification and I spent part of the afternoon watching live coverage of the kettling of Montreal anti-police violence protesters blocks from where I had been staying the previous week. Living in Asclèpiade was like being in a bubble of peace and care, and it was strange to imagine the passions of the real world outside. We had become a family, concerned for one another and cared for by the nurses and staff.
Sunday, the fourth day after the operation, I had my dressings removed. This was done in the late morning, in the bathroom with the examining table, feet in stirrups, by Louise. The dressing was an uncomfortable lump, bigger than any packer, made of layers of stiffened gauze, by this time stained with blood and urine. It was firmly attached to the sides of the pubic area with sturdy sutures which had been pulling at my flesh for several days, so it was a relief when these were cut. Louise delicately removed it, layer by layer, softening it with water. The last bits, inside the folds of my vulva, tangled with blood clots, were left to come off by themselves in the baths I now had to begin taking several times a day. She removed the little bag full of blood and the drainage tube which came out through a little hole at the side of my pubis. The catheter was left in for the time being.
I was handed a mirror, and finally saw my new genitalia, while Louise gently explored and examined the area. It was ghastly. Like one of Dr. Frankenstein’s early experiments, a seemingly random patchwork of different colours and textures of bruised flesh stitched together along raw, scabby incisions. The phrase “chopped liver” came to mind. The bruising in my upper legs and lower stomach had begun to appear a couple of days previous, and by this time was spectacular. When I closed my legs, I did not have the svelte V that I had been looking forward to, the whole area being swollen. I felt rather delicate, a bit horrified, but much more comfortable without the dressings and sutures.
Louise spent a long time examining the lower part of my vulva, and when I asked if there was anything wrong, she said everything would heal and be perfect. Later, Dr. Brassard visited, and also spent some time examining the same area, but reassured me that everything was healing well. I noticed he didn’t spend as much time looking at Donna’s. I tried not to worry.
I wished I had flowers. I had thought about it when I was preparing for my trip, and had almost decided to order myself some flowers to be delivered from a Montréal flower shop, but in the end decided it would be too much expense. Without expecting it, I had hoped that someone, such as my siblings who could afford it, would arrange to have flowers delivered. Or my visitors. One mentioned that she had wanted to, but in the end had not found a flower shop on her way. She was a dance friend from Alberta, also visiting Montréal, who came on Sunday. It was nice to have her visit. The virtual Lilies of the Valley a friend had sent the day after my operation were a consolation every time I opened my computer.
In the afternoon the nurse returned to examine our vulvas and explain the next phase of our self-care regime. We were encouraged to keep our genitals uncovered, and our legs apart to get lots of air. We had to have a soak in the bath, or sitz bath three times a day. The bath had to be cleaned and disinfected, this was done by the staff, but we were given instructions on how to do it at home. After the bath, we had to air dry, then apply Polysporin to the main front incisions using a precise technique to get the right amount in the right place in the most sanitary way possible. Then we could dress with maxi-pads and disposable panties if we wished to get up.
Constance had made a special dish for supper; real French Canadian poutine, with home made french fries and gravy and fresh cheese curd. She even made a special vegetarian gravy for me. Tom was not feeling well, he had a slight infection on his thigh where his skin graft had been taken, and he had his supper in his room. Jessica had also had a complication, her urethra was stuck on a blood clot and couldn’t be removed. It was a high spirited time for the rest of us; Kayley getting French lessons from Constance and trying out absurd phrases, and Ryley cracking jokes. There was a new man, from Vancouver, originally from Africa, scheduled for his surgery the next morning, a little subdued and overwhelmed by our antics. After supper I helped Ryley clear the table, despite the protests of the hard working staff, who were in fact grateful. It was a habit I had picked up from him, and continued doing it until I left. That evening we had a “party”; a few of us sat up and watched movies in the living room, ate chips and drank pop, kind of a goodbye for Ryley, who was leaving the following day.
That night there was a full moon. It shone in through the south facing bedroom window opposite my bed. I let the moonlight shine on my vulva, feeling that it might also be good for it.
On Monday I went for my first walk outside, with Ryley. The sun felt bright, and the cold crisp air was invigorating. I felt great, but walked carefully on the icy path. We went to the clinic next door, and visited with the nurses and staff.
Renée had a serious complication. Her urethra had swollen up after the removal of her catheter the the day before, and she had to have the catheter replaced. It would stay in for another week, and she would have it removed by her doctor when she returned home. My catheter was removed without problems. It was a relief not to have the little plastic penis tucked into the waistband of my panties, and getting in the way of cleaning and dressing. However, peeing became messy, a random spray rather than a stream. I found I was also having a problem with incontinence. I was having to urinate often, and when I thought I was holding it, I would discover I was in fact leaking. I took to wearing adult diapers for meals and walks, and began to worry, but this problem diminished after a few days, and eventually went away.
Donna and Kayley had their stints removed from their vaginas, a process that was a bit painful and uncomfortable, they told me, but a great relief. As I had not had the full vaginal cavity created, I did not need this procedure. What was even better was that I didn’t have to dilate. The other 5 gals were all now occupied dilating five time a day, a process that took them up to an hour, including all the douching and cleaning of the dilators. So except for my roommate Donna I didn’t see as much of them, and spent more time with the men and on my own.
In the evening Terry came to visit, and I also had a Skype meeting with the Transgender Awareness Week planning committee in Saskatchewan. Terry was used to me having to split my attention, including her in the meeting, this being the third time one of our visits had coincided with a Skype meeting. As a transactivist herself, I think she found it interesting.
I spent a lot of time the next day working on the final stages of the Saskatchewan Time 4 Rights campaign, and getting ready for Transgender Awareness Week. I also began to think about the coming battle to get better health care for trans* folk in Saskatchewan. I had been struck by the fact that of the 10 people who had genital surgery at the clinic the past week, and all the ones I had met so far from my second week, only two of us did not have full funding from our provincial health plans. Renée, who was from the States, and myself, from Saskatchewan. I could have applied for some refund from Sask Health, a maximum of 15% or 30% depending on the interpretation of the guidelines, but I had chosen to fund it myself to avoid the three year wait and all the red tape and extra travel expenses for assessment at CAMH in Toronto. However all the others, from Québec, Ontario, Alberta and British Columbia were getting 100% paid directly by their provincial health plans. The guy from Alberta was even getting his travel costs paid.
I had another visitor, a beautiful androgynous genderqueer person from Saskatoon, a friend of my son’s. A crossdresser and drag queen, they had been impressed by my being out and proud in Saskatoon, and felt they had to get to know me. They were interested in the clinic and my surgery, obviously gender curious, if not transgender. For someone who had come to the Brassard Clinic expecting to be alone, I was finding myself blessed with companions and visitors.
My last day, a week after my surgery, began as usual with a freshly filled icepack and a mug of hot milky tea in bed. It had been a long and difficult night, but as usual I felt better after my tea and breakfast. I was still taking two Tylenol tablets four times a day, antibiotic and an anti-inflammatory twice a day, and a couple of Dilaudid to get through the night. Generally I was not bothered by pain, unlike some of the others. Mostly mild, and only occasionally severe discomfort. I had continued to exercise, mostly walking and gentle stretches, more than some thought was advisable, but apart from Ryley, whose operation wasn’t as invasive, I was the one with the least pain and complications, and in the best spirits. Of course it also helped not having the vaginal cavity.
There were goodbyes. Dean left in the morning, and Renée left with her father later in the day. I spent some time taking pictures inside the Asclépiade. I went outside to the corner and across the street from the clinic, and then walked around the outside of the Asclépiade to see the other side, and the view of the park and the river.
That evening Terry and Emmanuelle came to visit me again. We sat and talked on the sofas in the living room. Terry, in her polyamorous way, put her arm around me, and I snuggled up to her as we talked with Emmanuelle about her hopes and fears about having surgery someday at the clinic.
I was not happy to be leaving on Friday. I had experienced a life change, in intimate and intense company. I would miss my sisters and brothers who had been sharing my journey through surgery and recovery. The skilled and caring staff at the Brassard Clinic and the Asclépiade had become friends.
I had chosen a mid-morning flight, with a generous three hour stopover in Toronto for a relaxed change of planes, arriving in Saskatoon in the late afternoon. I had requested wheelchair service, as recommended by the clinic, which turned out to be a great help. I took the maximum dose of all my painkillers all day, and was high on the opiates, with little discomfort. I also had the unbelievable luck, on both planes, that they were not full, and I had three seats to myself. The only problem was that my suitcase didn’t arrive in Saskatoon. It came a few days later. I had my basic hygienic supplies and medications in my carry on bag, so I took a taxi home, was reunited with our cat, and went to bed.