Medicinal pains and the cost of being me

Going to the doctors can be quite the experience when your transgender.  Up until I needed to transition I used the same family doctor as my parents and with him being local it was no problem to visit for any random sniffle.  Not anymore though.  The doctor I have to use now is a bit over an hour away, more if traffic is bad in the Pittsburgh area, but I needed a doctor who understood and could handle situations that may arise in the high risk arena of transition. Sadly, this is only a minor cost and inconvenience in the grander scheme of things.   Doctors specializing in transition based care are very hard to find, and when you do find them they are hours or even states away.  Now, let me run a couple numbers by everyone for a minute.  The numbers vary greatly in location so I will use and for my references and numbers I have heard from around different friends.

The low end costs of a transition can range between $40,000-$50,000 dollars.  Ok, now let’s hit you with the fact that some spend $80,000-$120,000 for transition.  Yes, those numbers are real, and they are the normal costs for someone who doesn’t have insurance coverage for transition care. Newsflash, 90% of us do not have that option as it isn’t considered medically necessary. These also go up every year.  For a small break down let’s examine just some of the expenses.
Hormones: My dosages cost an average of $15/month and are covered partially by insurance
Therapy: Average cost is $50-$200 per month for 1-3 years. This must be listed as something other than Gender Dysphoria.  If listed as gender related, it is not covered.
Blood work: Every 6-12 months I have to have levels taken for my safety.  This is not covered and cost me $300 when discounted by the hospital.
Doctors: My copay for a visit is $40 and I need to see him 2 times a year at least.  Add in gas for 110 miles round trip.
Hair removal: My quote for laser hair removal of just my face was $3500 and I have a very light beard that I can shave every three days or so without anyone noticing.  Don’t forget the very light chest hair that wasn’t included in that quote…
SRS: This is also know as Sex Reassignment Surgery. This can range depending on the doctor and also brings consideration to finding a good facility.   I know of 3 surgeons in America that offer this and the closest to me is almost 5 hours away, Thailand is also an option but only a few choose that one. I could not imagine the pain from that surgery tied with a 14+ hour flight.  Average range is $15,000-$30,000.  A friend just had her consult and she has to spend $21,000 for the procedure and $1000 for her two week stay.  No insurance coverage here either.
FFS:  (Facial Feminization Surgery) This is not always required but many need it for their own self esteem.  $5000-$15,000.
Breast: A girls best friend right. If the hormones don’t promote enough change, add another $5000-$8000 to make the girls how they should be.
Voice: Some of us are blessed with an amazingly good sounding voice from the start. Others don’t so they have two options. Voice coaching $1200 average to vocal surgery $6000.  Also surgery is poor at best and many end up raspy or squeaky.
So this is just a small portion of the total cost.  Add in clothes, shoes, jewelry, and other things any female has collected her whole life and we start to get a picture of what financial life is like for a Trans person. Sad that the costs can prohibit many, including myself, from being our true selves. Now let me add one more level more personal to the issues we face.
I have read many stories about Trans discrimination from people in the medical field. The one that has stuck with me the most has happened more than once in America alone. Emt’s on the scene of an accident and one of the victims in Transgender.  In this situation the transgender person died only because the “professionals” did not stop laughing at the woman long enough to administer life saving treatment.  Maybe we can speak about the doctor who refused to treat one of their long term patients because she transitioned, she died later that day because she had a stroke that could have been prevented.  Maybe we can view the therapist who felt that curing a trans person instead of treating them, leading to that individuals suicide.
I will speak for myself though.  Everywhere I go to get treatment I have to list all medications and this includes my hormones. From going to the dentist, emergency rooms, or urgent care I have to either A:) be force to come out again to every doctor or B:) make up an excuse to why I’m taking estrogen. Mood stabilization was my go to for a while but after I decided to quit hiding I realized that many in the medical field have no clue or experience with a transgender person.
I had to go to the ER for an abscess tooth a few month back.  I was swollen and in severe pain and after finally getting into the room I was asked about why I was on my hormones. I kindly explained that I was transitioning and after a long confused look on the nurses face she very apprehensively checked my mouth, had a script wrote out, and had me out the door in no time flat.  I’ve never been discharged faster in my life, almost like they tossed me out so I didn’t contaminate the others.  Just imagine the looks I get when bringing my blood work to the check in desk.
So let’s sum this all up for you all.  Medical treatment is poor at best unless you use an educated specialized doctor, your health can be a joke to first responders, and your pain means nothing because your different.  Thousands of dollars to be yourself all while hoping you don’t lose your job so you can afford to pay your bills and support a minimal life.  It is amazing to me that with the costs involved many still think that being transgender is a choice or fetish.  Sadly it is life or death to us and without insurance company’s willing to help with our medical needs we are doomed from the start.  I guess it just weighs on my heart to think that my life is not as valuable as another’s according to insurance company’s and the medical field.  Here’s to another year of using the (wrong) men’s room at work because I sure don’t have $22,000 laying around.


Employment in a changing society

Jobs are hard to come by in the current economy.  Finding anything over minimum wage can also prove to be more difficult and add to that being different and you have a recipe for unemployment beyond compare.  This also leads to a record number of homeless transgender people.  Could you imagine walking into a job interview and not even having a chance because you don’t look like someone thinks you should?  It happens everyday to people like us.  

In my transition I have met many people from different backgrounds.  Some from the steel industry, others educated in accounting all the way to doctors and lawyers yet we all have a single similar problem.  Acquiring and maintaining a job capable of paying the insane costs of transition.  Imagine having a degree in accounting and a project management certificate and after transition only being able to find employment at a clothing retail store.   Some are able to retain their job as one of my first transgender friends did working in a mill, but this is exception more than a rule.  

Fighting for workers rights is not new, but for a transgender person they flow much deeper.  Just finding a bathroom to use can cause issues.  In my case, I have not had surgery so I am to use the male restrooms and the looks I get somedays can fall between scary and humorous.   In the case of the mill, a special locker room was arranged just so this person could shower and change. Basically telling this person you don’t belong in either place.  Sometimes though, the pains of employment can and have flowed over to the loving spouse who stayed.  

I have a friend who I have known for years now.  Sadly she has moved away, but I still try to keep up with her activities but it is a bit harder being hundreds of miles apart.  Her wife was a pastor at one of our local churches and after her spouse started transition she made the brave decision to stay.  This decision also cost her more than she could have ever imagined.  She was told that she should leave but the love was to strong so she was later removed from her position because she would not divorce her vulnerable spouse.   To lose your job because you loved and supported your spouse would be unheard of in any situation other than ours.  Now not only is the transgender person seeking employment, but so is a spouse who did nothing more than love.  

Is it all about the look or is it more?  There are many types of people in this world but when your transgender there is one word that seems to define everything we do.  “Passing” or “to pass” is when referenced if they appear how they feel. Are they male or female enough to blend in. Every day I see others asking if they pass and it hurts to think that someone who has to fight off one stereotype is obsessed with fitting into another. To pass in society is to blend in or be invisible.  For someone to have no idea you use to be anything other than you.  This is rarely possible with transgender people.  Your history is always there in any background check normally causing an instant rejection before ever meeting the individual.  Sadly, this is more common than you would think.  Guess we can start to see where that 41% suicide rate partially stems from. 

I personally have been very lucky.  I applied to my company as Michael and worked there for almost four years before I changed my name.  Now as Ali, I have had more opportunity to advance and grow.  I do not feel inhibited by my gender anymore.  I state this with a pang of guilt also.  When I apply for a position knowing that I have an equal shot as the others, I think about my friends.  I think about all of those who do not have the luxury I have at my company.   It pains me to think that others out there struggle daily, just as I did at one point.  Up until Tuesday when I was dressed for my interview in my black dress pants, black flats, and a cute shirt I was just worried about keeping my job.  Now I am on a one tract mind to pave the way for other transgender people to have a better life, an easier time.  

In the end it isn’t just about being ourselves.  It isn’t always focused on us.  Being transgender affects more than just the person.  It affects wives, family, friends, and everyone else important in our lives.  Maybe someday a transgender person will not have concern for her height or face.    Some days it seems like we are all back in the times of segregation and the now hiring signs no longer say Irish need not apply, but they now read Trans need not apply.  I feel this day is fast approaching.  I feel that the rights of everyone will be equal at some point soon. No longer leaving a doubt that a transgender person was always a female or male, not just when they transitioned, but always.  

Another day, another stereotype, another box to check

Many days I sit and think about some of the interesting questions I have been asked and the statements that have been made not in jest, but in confusion.  We live in this society filled with boxes to check and signs to follow.  You must be one thing or another for the sake of others.  I am none of this.  I can not check a box and say this is me thus leading me to other questions. What should I be or not be?  If I identify as female should I be forced to give up something I love?  Why did I enjoy past experiences like football, yet still feel feminine?  What box do I belong in when I’m not even able to define myself? 

All of this causes angst in my life. From petty basics like social situations to the idea of bathrooms and where I should be in it all.  Sure, I have my taste and style differences with what could be considered common in a female, but what woman doesn’t.  I love skirts, dresses, heels, and other feminine things but I despise make up and think the person who created the bra was a sadistic prick.  I also love to get dirty. I love working on cars, doing remodeling, and the joys of knowing I can build things with my own hands.  Washing my hair afterwards is a pain though. With this balance, where do I belong? Even going out to an event for my kids I even have to question if I look right when I feel wrong.  I’ve spent 34 years trying to fit into a box that should not exist. 

My hobbies and enjoyment are far different than what most consider common for someone identified as female.  I love to restore and drive muscle cars and I have an extensive collection of firearms ranging mostly from the WW2 era and older.  I love the thrill of shooting my historic pieces and boy do I love the rumble of a classic V8 engine.  I am also a member of a fireworks team.  I love the joy that comes with shooting a show for the enjoyment of others.  Since I was young this is what I learned and enjoyed. This precursors to one of the questions that I am frequently asked.  How can you feel your a female when you love such manly things? As if what I love should define who I am.  Sure, if your on the outside looking in I was a stereotypical man but on the inside I was anything but manly.  Maybe it was overcompensation or maybe it was my escape. 

What exactly is a man or a woman?  Does it all boil down to genetics or is it something more?  When defining a man or woman, would you see the old outdated stereotypes or fall to a more modern view?  Preconceived notions that fall into the abyss. Not all women are weak, not all men are strong.  Many men these days can’t even check their own oil but they are still men.  Women are no longer soft, gentile, and viewed as inferior.  Is it really that odd for a woman to love guns and cars?  

The anxiety I live with because of all the questions is hard to describe.  It is based off everything I know as myself, yet can’t seem to define.  It is also clouded by the stigma attached to what transgender people are. When I feel confident in a small group I can concur the world, but put me in a large group where I can blend and I feel like I am the one they are all looking at.  Somedays feeling beautiful and other days feeling like a man in a dress.  Heck just to go to one of my kids events I have to sit and calm myself in the car, run in as close to start time as possible, and run out as soon as it is done.  This should not be, yet it is all things culminated from a life of feeling awkward and uncomfortable.  

So where do I fit in the puzzle? Why should I give up what I love to fit into a box I don’t belong in.  I will always love the things I do, from the joy of rebuilding a car from nothing all the way down to looking pretty in a dress, but in the end we are all different and we all have a role to play in this world.  I gave up on defining myself and decided to just be genuine and if that doesn’t fit handily into a little check box, I’ll just have to fill In the blank instead.  

Image credit to Pinterest, Vanessa Paradis

Names, pronouns, and balancing on the fence

For years I have questioned who I was and how I should have been.  Somedays I felt like the driver yet other days I was a passenger in my own mind. I had to cover up who I was, like a caterpillar in its cocoon, to create a shell against the outside world.  Fearing the reality of never knowing what normal felt like was a daily pain.  I came out slowly and have transitioned slowly just enduring the pain to try and give my wife, children, family and friends time to cope. As I was coming out I feared I would lose everything. I remember the depression and fear of losing my wife (I still fear losing her) and the life long friends I had come to love.  Most all of them are still there even when it is difficult they have all soldiered on.  Amazing how many people can surprise you.  I am now the butterfly who has left the cocoon, flying off into the unknown. 

So after years of struggle dealing with it all I finally spoke to the HR at my store.  Now being a very large home improvement chain in a store that employs over 150 people this was a crazy stressful time. I found that there was support beyond belief.  I also found that it is a real pain some days to be me.   Even though my legal name has not been changed I was allowed to change my name tag to reflect myself.  This small piece of paper that represents an identity gave me a feeling of congruency I have lacked for years. It has also reveled something I did not intend: more struggles.  Not only for me to be patient and kind in the adjustment, but also for my coworkers who try their best to change with me.

To some it is just a name, to me it is reality.  I smile every time I hear someone call me Ali as it feels natural, an innate feeling of self. In this reality though there is a flip side.  I have always been Mike at work.  Employees and managers have known me since my first hormone dose and have watched my looks change. They have a recognition and it is just natural for them to call me as I was.  It stings more than a hundred needles. Strange feelings come when hear that name. That isn’t me.  Here is the problem, I am not legally Alissa so I can not, nor would I feel comfortable to, force someone to call me Ali. For two weeks now I have been stuck. Stuck between who I was and who I am with only one thing left… Facebook.

That old adage we hear that it isn’t official until it is Facebook official seems to ring true in many ways.  People posting news, weather, coming out, relationships… It is all there just as a reminder of who is doing what today.  To me, I hated being on Facebook.  I hated seeing the name that was the fake me and the pronouns I did not fit.  I am not a male, but I am not yet female.  So after talking to a friend I am close with, yet never met (that’s to social media), she told me of her time and how she just had to rip off the bandage.  I agreed, but had to worry about the wife, kids, and parents also.  So after some conversations, I posted a cryptic message, because that is just how I am, and later that Sunday I changed the last piece of me over.  I no longer had to see that name anymore.  I was finally me.

The relief is unbelievable and it still amazes me what a small change like that can do to ones self. I did not make a huge deal, I did not make some huge post. Some noticed immediately, others didn’t notice or maybe they don’t want to see, but I see it and that is what matters most.  I am no longer straddling the fence and no longer hiding myself. I am out as myself, happier then I have been in years, and the best part of it all is I can celebrate my 34th birthday at peace.  I am now Facebook official and though my body may be a work in progress, there is nothing wrong with my soul anymore.

Wives, children, and the great balancing act

I was watching TV last night and I saw the NBC special on Jacob and his family.   It was a breath of fresh air to see a transgender child in a positive light just as Jazz has been.  This shows that being transgender is not just a phase or crazy thought but a life long struggle that some deal with longer than others.  I am proud of the children but more so, I am proud of all the parents willing to take the steps nessasary to make their child happy.  The unsung heros in the battle of dysphoria.

Many times I am asked how my family copes with my situation and somedays I truly don’t know.  I have a wife and children who mean the world to me yet I seem lost at times.  Questions in the great unknow flowing through my head like a cascading river.  As a spouse I need to be part of a team team able to acomplish any mission and as a parent I must place my childrens needs above my own all while dealing with a dysphoria that can consume ones life in the process.  It is a balancing act that goes on daily with no end in site.  My wife has had a rough road in this story and yet she continues on with me and I thank her daily.  She has been there for every doctors appointment and every depression.  She has also given me the greatest gift ever, my three beautiful girls. 

As parents we must always realize that every action we take shapes our child in certain ways.  Children learn by their suroundings and environment just as much as through their genetics and culture so anything laid out before them is a learning opportunity.  We must teach them that not everything is black and white and that pointing out flaws is not acceptable.  We must also let them grow in hobbies.  My youngest loves art and drawing, my middle child loves hockey, and my oldest is a barrel racer.  All intersting fields and all areas where someone like me just doesn’t fit in yet I try to be at every event just a true parent should. They view people for who they are, not what they are nor are they embaressed by the fact that I am different.  They almost brag about it.

Speaking to my children about their daddy being different than others can be hard, epecially if you think they should keep it all secret.  I will say that my younger two (7&9) have mostly grown up looking at me in dresses and girl clothes so to them, it is normal but for my oldest (14) It was tough. She did not see most of it until later in life and being 11 at the time, she had enough of her own issues to deal with let alone me adding more to the mix.  Needless to say that conversation and many to follow were difficult at best.  I had taken what she knew was her dad and showed he a side she had never seen before.  In those moments I felt that I had failed her.  She spent almost a year not wanting to speak to me about any of it.

My oldest is like me in many ways, She can hold a grudge past forever and boy does she have the attitude.  Her love of music however was her release.  It was also how we reconnected. I was working on a paper for school listening to one of my favorite groups, Against Me!, and more precisly I was listening to the “Transgender Dysphoria Blues” album.  She walked by and slowed down just out of interest at the new sounds she had not heard yet and later that evening she asked me if I would allow her to listen to It more.  She listened to it non stop for days, even singing some of the songs as she further enjoyed the education that was coming along with the lyrics.  Later that week I was approached by her to have a talk about the whole situation and was I shocked when she said “I understand what you have been dealing with and I love you no matter what, I love you either way”.  Laura Jane Grace and Against Me! had not only helped my child cope with something others never even knew existed but she also gave me hope for a better future.  Against me not only saved us, they gave us an amazing memory as that became my oldest daughters first concert.  

No matter how I look or dress, I will always be their daddy and that will never change.  To be different is to be real and to survive this journey my wife and girls have had to transition along with me.  Even when it seemed impossible they stuck through it all. In no way can I say it has been easy on my wife and kids but I can sure tell you it has made them stronger. 

“Life’s a transition, everyone’s in transition. I’m not who I was yesterday and I’m not the person I’m going to be tomorrow. I’m just figuring out as I go along, just as everyone else is doing.”  – Laura Jane Grace

Life, liberty, and the pusuit of normal 

Morticia Adams once said, “Normal is an illusion. What is normal for the spider is chaos for the fly.” Normal is what most people strive for in society, but what is it in reality? Normal is imaginary and we are all just illusionists trying to fake it to fit in. While cruising different sites, I see the same old statement repeated day after day. “Why does (insert abnormality here) have to be like that… they should just be normal like the rest of us.” The answer to that lies in ourselves, our generations, and our cultures.

When I came out to my family, I thought that I was going to destroy one of the most dearly held things in my life. I started by talking to my sister and brother-in-law. Now when my sister and I were younger, we were like oil and water. After she married and moved away we became very close. This conversation was the first of many that I truly can not put into words for others to understand. I remember dialing the number, listening to the light rain, and waiting until she answered. Time stood still and my stomach was in knots. When she picked up I proceeded to tell of the heartache I had carried, and the pain I could never show anyone but my wife. My sister did not even know how to respond and I truly could not blame her yet she and my brother (in-law) talked to me for a good while after to make sure I was truly OK. He is truly an amazing and caring person that words could not do justice. The fact that he cared as much as my own sister did was truly amazing.

After that call came the inevitable, my parents. To be honest, as I look back to that night I realize I should have done it much differently. My dad worked on the road as a repair tech so he could be gone three plus days at a time and he is very soft-spoken so conversations are limited to very short answers. I ended up only telling my mother after she came home from work because he was not in town and I could not hold it anymore. I know the feelings I felt and surely could not begin to imagine what emotions flowed in her head as I spoke. We cried for a while. Her for the emotions I caused and I for the pain released. I wimped out telling my father but, for how close my immediate family is, he found out soon after whereas I should have told him myself. To this day he and I have never truly sat down and spoke about it even though it is the elephant in the room no one talks about.

I visited my parents almost daily until that day. From then, I spent over three weeks in hiding because I feared that every coming out story I had ever seen was reality and I would be disowned, beaten,  or just no longer welcome. All I can say is don’t always believe everything you hear. It has taken a long time for them to accept as I would expect, because it took me over 15 years to accept it myself, but they are still there and they still love me. I will never forget the day my mother told me that “A parents love is unconditional.” To say I tested that is an understatement.

It took almost two years for my sister to be ok with everything and the day she actually told me that, I cried tears of joy. The feeling of knowing I will always have her in my life was sheer joy. I still visit my parents almost daily and although the thought of my parents seeing me as Alissa still scares me a little but let me tell you they are there for everything without question. My mom and I have slowly started talking in little bits about it so we can work through it all but considering the circumstances I could not ask for more. Like I said before, one amazing family.

So this leads back to the word normal. To be normal like I seemed to be was a lie and it was told to everyone I had ever known.  When my time came to tell my story, I had to prepare myself knowing that I could have destroyed everything. Coming out is not easy for anyone when it comes to being transgender. It can and will test every relationship you have ever built, even the ones closet to your heart. To me it felt like life or death but to a family it is death. It is like I am killing the son they gave birth to and hoping they can accept a daughter in his place.

To those of you planning to come out I want you to know that it is not always the end and I am sure other successful stories are out there. I made mistakes in how I played out my story, but was lucky enough that my family could handle my errors.  You are not alone out there and even though you feel like it is the end… your journey is only starting.

From the beginning

I am going to take you on a journey back into time.  A journey that brings back many strange memories and many firsts.  I was born in 1981, the son of two amazing parents and an awesome sister.  Everyone was excited to see the only boy born to carry on the lineage.  Around the age of 5 I started to feel different, yet I had no clue as to what it was.  I played with the kids around town, rode bikes in the rain, and did everything a boy was supposed to do but it just didn’t feel “normal”.

Many years passed and I still had that feeling of being different, I was an outcast that did not fit into the box I had been placed in and without the internet I was alone.  As I grew older I had to hide my true self to fit into society.  I felt alone in a family full of love and an empty shell of the person I should have been.  Participating in football and the band I found a small escape from the mental pain.  It only helped for so long.

I quit football in tenth grade and concentrated on playing in the band to continue the path of music but the internal struggle was becoming very deep and this is when I broke.  I could not tell anyone about what I was when I did not know myself and the pain in my head became too great thus leading to the first of many attempts to take my own life.

I managed to make it through to graduate high school but what did the future hold for someone like me.  I managed to secure a job working for a local heating and cooling business and also helped a friend in his business.  I also manage to marry one of the most important people in my life.  My wife and I have been together for 14 years now and I will say she is the strongest person I will ever know.  A few months after the birth of our first daughter I had to sit her down and tell her the pain and she was the first one I let into this world of mine.  The thought of breaking her heart terrified me more than anything because I had (and still have) true love for her.  After her and I moved into our first place I started searching the internet fo clues, answers, or cures yet no magic pill was ever found.  I did however find an amazing person that did not live to far from me who took me under her wing and helped me find the answer to my questions.  Transgender… The label hit me like a ton of bricks.  Like I was an actor in the Springer show, but I can’t be one of those people can I.

Hitting 28 I hit a wall.  I was lost in a sea of thought without any outlet.  Something needed to change, and with the help of my father I finally enrolled into BC3. If there was ever a change, this is the one that saved my life.  In my second semester I had a professor of English who gave what should be a simple task… write a story about yourself.  Well here was a conundrum, who was I to be in this paper, the fake male facade that I showed the world or the inner female.  Well let me tell you that in that class I wrote about the real me, the frightened secret me who was hidden away for years.  I managed to come out in front of a class full of strangers with nothing more than a professor who would not let me give up.

As I continued in my travels with school I was enrolled in a Psychology class with another amazing professor.  She opened my eyes that there was more to life than just “normal” people in society.  She forced me to become more than just another student in the classroom and as time moved on, she became an amazing supporter of me and has stood behind me to push me to the next level.

I sit here now as an almost 34-year-old who did not think I would live to see 21 with some amazing stories that I can tell.  I will say that as this blog progresses I will speak more of the people in my life and the educators who made me the person I am today.  I am Ali, the woman who I repressed most of my life.  I have grown to learn that there is more to life than a label and not to use that same cliché… It gets better.