Genital Confirmation Surgery (GCS), March 2019

Beach waves at Monterey, CA

Monterey, CA

I meet with my surgeon the afternoon before surgery. My appointment has been re-scheduled twice; once because traffic is preventing me from arriving for an earlier appointment and then later because the doctor is running late.

This is the second time I’ve met with her and it’s an opportunity to ask any last-minute questions.

Do I have any?

No. We covered everything the time before.

She asks me a question: what are your expectations?

This question gives me pause. I realize I’ve never really thought much about expectations.

I know the whole reason I’m sitting here is because my expectation is that she will re-configure my genitals to conform to what my brain tells me should be there. Beyond that…

‘I don’t know. I don’t really have any,’ I blurt.

She seems surprised by this and starts mentioning a few things that include depth and appearance. I don’t want to look like a complete idiot so I spill out a couple.

‘No infection. Orgasmic.’

‘What about appearance?’

‘That’s out of my control so I don’t worry about it.’

We chat a bit more and she seems satisfied with my answers. My surgery time has been moved from 07:30 to 11:00 since there was a power outage at the hospital today and she had to bump her afternoon surgery. News of a power outage gives me a moment of pause but I’m cheered that I don’t have to be at the hospital at 05:30.

She hands me the bowel prep kit and gives me an overview of how to use it, directions to the local Walgreen’s to pick up some other prescriptions, and then I’m sent off with a, ‘See you tomorrow!’

My friend, who lives in Monterey and who I’ll be staying with, has been patiently waiting and we walk to the pharmacy down the street to pick up the prescriptions and some last-minute supplies. My mind is overfull, and it’s all I can do to focus on where we’re supposed to go.

Waiting in line at the pharmacy, an older woman sitting in a chair waiting for her prescription comments on my backpack by asking me if I’m going hiking. I mumble no. Talking to other people is hard right now.

I wonder how many other trans women have stood in this line waiting to pick up their medications. Hundreds? At least. Thousands? Easily. I see myself as another in a long line stretching back in time and others queued up behind me for the future.

I’m really here. I’m really doing this tomorrow. Right?

The pharmacist says my meds aren’t ready. Maybe fifteen minutes. My friend and I make our purchases and I’m looking at the map app and see there’s an Apple Store nearby. I need the trackpad on my Air fixed so we hike down the street and it’s only after I’ve gotten into the queue that I realize I forgot to pick up my prescriptions.

How the hell could I forget? I guess I’m overwhelmed. I have things on my mind. The years it took to get here weigh on me like slabs of polished granite, squeezing the life ouf of me and compressing me to jelly.

Breathe, Heather, breathe. You’re almost out from underneath them.

My friend holds my place in line and I trot back up the street to the pharmacy. There’s no line and the cashier rings me up and passes them to another counter where I have to get counseling from a pharmacist. I didn’t ask what all the prescriptions were and I pick them up and start to read. Oral antibiotics. Painkillers. Antibiotic ointment.

The pharmacist sees me and comes over. Do I have questions? I don’t and I’m off again. It doesn’t occur to me until I’m back on the way to the Apple Store that for all the trans people that have gone through that pharmacy, I never saw the knowing smile or smirk I sometimes see or heard the gentle condescension I sometimes hear.

Apple doesn’t have my part in the store but Palo Alto does if I want to go there? Or come back in a couple of days? It’s getting late so I thank the nice man for his time and my friend and I head back to the hotel.

There are two doses in the bowel prep kit and I’m supposed to have them about five hours apart and nothing at all to drink after midnight. I was supposed to only have clear fluids all this day but I screwed up and had eggs for breakfast so I’ve been pounding Gatorade to flush everything out.

It’s close to 20:00 so I get mixing and drinking. It tastes awful. A mixture of three different salts, the manufacturer decided to overdose on sweet flavoring to mask the salts. It tastes like salted and distilled Mountain Dew. My first batch goes down reluctantly in about 40 minutes. I decide I’ll start the next batch at 23:00 and I spend the intervening time sorting and packing for the hospital.

I pack a couple of pairs of pajamas, some shirts, underwear, a light sweatshirt, clothes for the morning, and my toiletries and phone. With hindsight, I ridiculously over packed. Besides my toiletries, all I really needed was the clothes I walked in with and the sweatshirt.

23:00 rolls around and I mix up my second batch of bowel prep. I can feel things rumbling from the earlier dose but nothing has happened yet. The taste, if anything, is worse now. The salted and distilled Mountain Dew now tastes like it’s been pumped through unicorn veins and boiled with glucose in spun sugar bowls.

23:45 rolls around, I’ve barely drunk a quarter of the dose, and the osmotic pressure in my bowels reaches a critical point and tells my nervous system to enter high alert: it’s time to go.

And go I do, beginning what turns into an almost all-night liquid sedimentary layer excavation of past meals.

00:10 comes and I’m trying to take small sips and then rinsing with water or orange Gatorade. It’s not working. There’s still easily two-thirds of the dose to go so I dilute it with what remains of the water I’m also supposed to drink. It’s still nasty.

By 00:20, I’ve choked down another quarter of the diluted version, run to the bathroom twice, and watched the color of my effluvium trend clear. I need to finish this. I top it off again, this time with the Gatorade, and this turns out to be the wrong thing to do.

Whatever sweetener in is Gatorade is close to, but not quite, what’s in the bowel prep, and now I’ve just poured high fructose corn syrup into the already devilish brew of sweet.

I valiantly try to complete doctor’s orders but at 00:40 I give up and pour my cocktail of Smurf juice down the drain, swish my mouth out with water, and pound another 16oz of water before dashing to the bathroom again.

I’ve set my alarm for 07:30 to give us both enough time to get ready and get to the hospital by 09:30. Again, my ambition outstripped reality.

Reader, I was up at least every half hour to void myself and it was awful. The cycle was thus: clean myself up from the latest purge, waddle back to bed, sit on edge of bed, do a body check-in, convince myself it was okay to lie down, lie down, feel the urge, struggle to get up and waddle to the throne without dousing myself, and begin the cycle anew, seemingly ad infinitum.

Some people, (mostly cis,) think gender confirmation surgery (GCS)* is the glamorous denouement of the gender journey, where the plucky heroine has surmounted all obstacles to attain serenity and appears dewy-eyed in the recovery room, while her scrappy but tough found family of friends cry tears of joy for her while holding balloons that say, ‘It’s a girl!’

Some people also think Trainspotting glorifies heroin use.

Somewhere around 05:00 I was able to start catching snatches of fleeting sleep, so by the time the alarm went off two hours later, I was a shell-shocked, empty vessel of sleep-deprived nerves with a tender bum. (20/20 tip: use baby wipes at the start, not after it feels like your anus is trending towards becoming a Ring of Fire.)

The brain weasels moved in while I was shaving my crotch in the shower and asked all sorts of questions and offered their unsolicited insights.

To wit:

‘Do you really want to go through with all of this? Are you sure? This is permanent and recovery is long. Sure you can’t just deal with your equipment? Lots of other people do. You might be able to get a partial refund or donate your slot to someone who can’t afford it. Is this worth it? Is this really what you want? You’re afraid. You can bail out right before they put you out, you know.’

Etcetera, etcetera.

Fucking brain weasels.

My transition required me to take agency to transition and not let those that opposed it or tried to deflect or slow me down take it away from me, and that includes brain weasels. So, I pack my bag and we leave for the hospital.

On the way, I realize that most of yesterday I felt a deep sense of calm and happiness. I take this thought balloon and tie it to my wrist.

I check in for surgery. There is little paperwork, it goes quickly, and then I’m off to surgical check-in. The nurse there is sweet and she shares a name with my mom. The last time I was in a hospital was when my mom died and I am overcome and I weep for a bit.

What do I feel? Everything.

It has been a long journey to get to this moment. It feels hard now, but the real hard work is past.

I go to the bathroom. I disrobe and put on a gown that’s impossible to tie without help and I’m grateful again for my friend who is here to help and comfort me.

An intravenous port is installed. I scrub my teeth and gargle a minty antiseptic, and it reminds me again how much I hate mint because of the time I gorged on too many leaves from my mother’s garden and became sick.

My blood pressure is a bit higher than normal, but I’m dehydrated and anxious, so it’s not a worry. There’s some paperwork to sign and then I’m swabbing my nose with an iodine solution and wiping my body down with antiseptic wipes.

I mentally Marie Kondo my penis and thank it for such good use over the years, but it’s time for it to go.

It’s almost 11:30.

The anesthesiologist comes in to introduce herself. I’ve never met her before and she’s about to have my life in her hands. I get a competent vibe from her and her bedside manner is attentive. She explains what she’s going to do and the only new news to me is that I’ll be intubated during the procedure. I hadn’t remembered reading or hearing about that before.

She leaves.

Things are getting more real by the second.

My doctor pops in and asks if I’m ready.


She vanishes and then I’m being wheeled down hallways on a gurney to the operating room (OR). This area is clean and I am comforted. I’ve never liked hospitals. The irony is that I’ve worked in two and been through so many emergency rooms as patient or advocate I’ve lost count. I idly wonder if all that time I spent in them was to subconsciously prepare me for this moment–the moment I dreamt about when I was five.

We enter, and I’m surprised. It looks very high-tech and different than the surgical suites I was in for the cesareans of my children. It’s a big room, easily thirty by twenty feet across.

Besides the operating table, there are a bank of four flat-screen monitors on the wall. Two display vital signs, one is a clock, and one is of a live video feed of the table. There are four surgical nurses arranging instruments on different trays and tables.

They have me hop down from the gurney and ask me what surgery I’m expecting today. Flummoxed, I have to read it off the clipboard, ‘Genital reconstruction surgery.’

I’m introduced to the team and promptly forget all their names because my mind is blank because everything going in is whooshing right back out. I thank them for caring for me as I climb onto the operating table, and they seem appreciative.

I am laying on my back and I’m asked to shift up a bit into a depression on the table around my butt. Properly situated, my arms are spread out wide, a belt is placed across my hips, and it is time.

I stare at the huge surgical lights looming above me. There are three, and each is about three feet across. There are translucent, irregular dimples scattered across the slightly parabolic surface that look like large blobs of slushy water frozen on. To distract myself, I consider why they’re like that and tell myself it’s so the light spreads irregularly through them to reduce shadows.

The anesthesiologist comes in and asks if I’m ready.

I’m terrified and want to say no. How the hell did I end up in an operating room to have my genitals turned inside out?

The question is absurd and asked by fear.

I didn’t arrange my life and make the choices I did to bail out at the last second from fear. That would be absurd.


‘Okay, let’s get going.’

My doctor enters and leans over me.


I want to say no. I want to flee from the room and live a life where I don’t have to worry about my body or my gender.


She asks the room what time it is. Someone answers, ’11:53.’

‘Are you sure?’

I can see the clock on one of the screens. It says 11:56.

‘Uh, 11:56. She came in at 11:53.’

‘Let’s get going.’

Someone moves just out of my vision behind me to the left. I think it’s the anesthesiologist.

I awaken briefly in the alternate universe of the recovery room, relieved I’m still alive. My doctor or someone tells me everything went well. I close my eyes, and open them in my private room. My friend is there, smiling. It’s afternoon and my crotch hurts and is swaddled in bandages. I can tell I have packing in me.

It is done. I did it. I made what I used to think would never happen, happen. I am proud of myself.

For the moment, I am content.


* Over the years, the surgery was known as SRS (sexual reassignment surgery) for a long time, then it switched to GRS (genital reconstruction surgery) or GCS, which are sometimes used interchangeably. Usage seems to depend on age, (older people tend to use SRS,) or personal preference.

©Heather Coldstream

I’m on Twitter @cistotrans

Please consider supporting my writing by sharing it with others with attribution and linking back or buying one of my poetry collections from the Kindle store. Thank you!

2016: Poems from a Year of Change

Uncertain: Poems About Gender Transition

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Moonlight over the Salish Sea in Seattle

It rained last night, but now it is mostly clear, and the moon walks with me to the bus stop in the pre-dawn, dancing between still-dripping Douglas fir boughs to drop moonbeams between shadowy places. Stars add their twinklings to the celestial show. All of them are my remote companions on their own journeys towards eventual transformations small and large. I meditate on the seemingly universal and eternal nature of change.

Nothing changes, then everything changes, then nothing changes again. I’m in a big everything changes cycle now.

My work, my relationship to myself, the shape of my body, my relationships to others—they’re all changing around. Underneath it all, the catalytic substrate I worked so hard to build will remain after all those changes. Then nothing will change for a while as I rest.

I’ll use that time to consider tearing it down or modifying it for the next round of change. But that’s the future.

The now is moonlight, starlight, dripping boughs, and the beginning of the last leg of a journey I started ages ago.

©Heather Coldstream

Please consider supporting my writing by sharing it with others with attribution and linking back or buying one of my poetry collections from the Kindle store. Thank you!

2016: Poems from a Year of Change

Uncertain: Poems About Gender Transition

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All the Feels


In the coming week, I’m having The Surgery and I have many intense feelings about it.

Disbelief, fear, anticipation, relief, excitement, acceptance, and gratitude.

Disbelief rides atop all. Am I really doing this? Is this really happening? Is this really my life? (Yes, yes, and yes.) Since it’s something I’ve wanted since my teenage years and it seemed unobtainable then, it’s hard to believe I’m here now.

There’s a certain detachment I have about it, which I think is coming from fear, and it’s not unlike the run-up I had to transition. After all, it is major surgery with potential risks and complications for something that doesn’t feel life-threatening for me.

Besides the physical risks, I have a fear of being on the other side and discovering it was the wrong thing to do; that it won’t address the self-doubt about being trans that burrows through my psyche like termites through wood some days.

I felt similarly about transition.

It was too huge a concept to keep all in my brain at the same time, so I externalized parts of it and only addressed what I could when I could. I have a feeling that like transition, I’ll be on the other side and ask myself, ‘Why did I put this off for so long?’ That’s cold comfort here in the fear zone right now but it doesn’t feel as black-box scary as transition once did.

I remind myself that if I’m delusional or misguided about it, I’ve gone to extreme lengths and overcome many barriers to get myself here. Occam’s Razor cuts towards I’m doing this for the right reasons.

The focus of my anticipation has shifted over the decades from titillation when I was a teenager to the more practical issues like being able to wear clothes that otherwise don’t mix well with my existing body shape and reducing risk if I end up unconscious and need medical help. I do still have anticipation about future sexytimes, but it’s on the list below other things.

Relief. Ah, blessed relief. I look forward to being relieved of having to tuck and worry about things shifting around down there. And relieving some anxiety about changing rooms. And relief from not having to worry about when I’ll have this step of transition behind me.

And I’m excited! Holy crap! How could I not be excited when I did so much work and had a bunch of luck happen to get me to the point of making a childhood dream come true?

Acceptance comes from realizing this is not the penultimate step of my transition, but just another, albeit large, one. Do I wish I had been born with a body my brain felt in congruence with? Yes. Do I think surgery will bring that congruence about? Not totally, but it’s the closest I can get at this point in time and I accept that as a positive outcome.

And gratitude. I’m grateful for the people who have helped me along the way by showing the way, by holding my hand in person or virtually when it needed holding, and kicking my butt when it needed kicking.

From the people in the USENET transgender newsgroups who first opened my eyes to the possibility of transition to the people of the Phoenix mailing list who shared their lives so honestly explaining what life was like post-transition to everyone at Ingersoll Gender Center in Seattle to friends past and current, thank you! I love you all. ❤

I’m very fortunate.

©Heather Coldstream

I’m on Twitter @cistotrans

Please consider supporting my writing by sharing it with others with attribution and linking back or buying one of my poetry collections from the Kindle store. Thank you!

2016: Poems from a Year of Change

Uncertain: Poems About Gender Transition

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Why I Switched Back to Oral Estrogen from Injection

[CW: graphic description of needle injections, statistical analysis]

Almost two years to the day after I started injectable estrogen, I switched back to oral last week. One big win of injectable for me was the general aspect of my body changed for the positive with regards to fat deposition, most noticeably around my face and midsection. But from the beginning I struggled with the method and side effects, and it was a bunch of little things across three things–how they made me feel, my hormone level response, and the physicality of it–that added up to change my mind.

There were pluses and minuses on how they made me feel physically and emotionally.

The largest positive was a ten-day instead of daily cycle. It was a relief not having to take and track daily pills and overall I spent more time in what I’d call a ‘comfortable glide’ mode where I felt physically and emotionally level.

On the negative side, I’d get really bitchy in the couple days before my injection and I had a persistent feeling of not feeling ‘right’ through the whole cycle. It’s hard to describe, but it was a subtle feeling like my blood pressure was elevated, (it wasn’t,) and just generally feeling out of sorts, like my life was somehow off a fraction of degree from level. It was a discomfort that at first I thought correlated to swings in my hormone levels, (see chart below,) but changes in time between dosages, (fourteen to ten days,) and the dosage quantity did not enhance or lessen the feeling.

My hormone level response was mixed to negative and my chart shows it, (injectable started March 2017.) For those new to my blog, estrogen is the only HRT I take; I do not take any anti-androgens and my doctor aims for a ~200 pg/ml estrogen level.

My historical hormone levels in graph/chart format

My historical hormone levels (Gray line is 2 period moving average)


Most noticeable on the chart is the significant drop then jump in estrogen after I started injecting. (For some reason, I didn’t get blood work orders for testosterone levels for a couple of months so I don’t have those numbers.) My doctor thought the 9 August 2017 result was a lab error, but a re-testing on the 20th showed similarly low levels, so we upped my dose, and then bam! the levels jumped way up; pregnant-high up. If only!

Even after reducing the dose, the next test showed estrogen even higher, so we reduced again. That brought things down by June 2018, but it was still elevated and we continued to reduce the dose. In winter 2019, another trans woman suggested I try a graduated syringe that measured in 0.1 ml units vs. the 0.5 ml units I had been using and you can see that even with a finer resolution on dosage, my estrogen still spiked up.

Meanwhile, my testosterone was doing its own thing. Serum testosterone seemed to bounce up, then settle down, then bounced up at the end. Free testosterone generally stayed well-suppressed, but during the injectable time period I had two of the 3 highest results, excluding my baseline.

From a statistical standpoint, things were mixed. I analyzed 5 different standard deviations, (and yes, I know these data sets are small so I used these as supplemental data,) SD1 was all data points, SD2 was all minus my baseline result, SD3 was the injectable timeframe, (17 Apr 2017 – 28 Feb 2019,) SD4 was oral minus baseline, (2 Jul 2014 – 11 Nov 2016,) and SD5 was oral minus the first two data points to account for getting to a hormonal system equilibrium, (2 Oct 2016 – 11 Nov 2016.)

Hormone level standard deviations data table

Hormone level standard deviations

I think the best comparison is between SD3 and SD5 and what pops for me is that under injectable I had larger swings in estrogen, SD3=402.4 vs. SD5=127.1 and serum testosterone, SD3=6.5 vs. SD5=5.6, but free testosterone was the reverse, SD3=0.7 vs. SD5=1.7. I am not an endocrinologist so I’m not sure what this means medically, but what seems clear is my body had a greater sensitivity to the estrogen in injectable form vs. oral and while my free testosterone was more stable, it still did not suppress it as well as oral estrogen only. The end result was that I never felt like I had a dosage that led to a stable range.

I found the physicality of the act of injection and the sourcing of the estrogen, needles, and syringes difficult.

Early on, I managed to put needles through my fingers and I experienced pain at injection sites as I sought the most comfortable place on my body to do it. I started with the top of the thigh, tried the side of the thigh, then ended up in the upper, outside butt. I still wonder how much of my variance in levels had to do with injection site and how much got where it was supposed to go in the muscle compared to other tissue or fat locations I may have ended up in.

I learned that I had trouble causing myself pain with the prick of the needle and had to look away, otherwise I risked swooning. This is how I managed to jab needles into my fingers. While injection guidance is to dart the needle in, I couldn’t do that and ended up at slow insertions, and for some reason that caused me less pain but it extended the time of the injection process.

Since I don’t like needles in general, the first several took me hours to work up the courage to do it and it wasn’t until the end that I had the process down to a few minutes. Compared to popping pills, it was a large time burden.

And then there was the pharmacy/insurance/doctor’s office iron triangle I found myself in over and over. Most of the problems were on the pharmacy side. They included the pharmacy not keeping the drawing needles, syringes with injection needles, and estrogen in regular stock, my insurance only covering generic but my pharmacy didn’t carry generic so I needed to get regular pre-authorizations, and dispensing me the wrong needle lengths. I spent hours sorting things out at the pharmacy and over the phone.

In addition to the generic vs. brand-name problem with insurance, every few months there were changes to what was or wasn’t covered, so some months I had to pay for the syringes and needles, and every six months or so it was, ‘Hey, the estrogen is $497, do you want that?’ and I had to chase down insurance and my doctor to sort those things out.

My doctor’s office was generally good about responding, but things did get out of whack when I asked for an extra needle/syringe/estrogen prescription as spares for when I messed up and for an emergency kit, which confused the pharmacy and messed up replenishment cycles.

In short, there was a bunch of friction around sourcing and the act of injection that was a constant source of frustation.

Taken all together, it just wasn’t working for me.

On a more meta-level, while I’m open to returning to injectable post-GCS, I wanted to go back to a more stable and lower estrogen curve going into surgery. I’m likely to have some changes after the testes are removed and oral allows for faster dosage adjustments up or down compared to injectable. I’m hoping to get back to a stable range and then maybe trying again.

<br />
&copy;Heather Coldstream
<br />
<br />
I’m on Twitter <a href=””&gt;@cistotrans</a>
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Please consider supporting my writing by sharing it with others with attribution and linking back or buying one of my poetry collections from the Kindle store. Thank you!
<br />
<a href=””>2016: Poems from a Year of Change</a>
<br />
<a href=””>Uncertain: Poems About Gender Transition</a>

Posted in gender transition, healthcare, HRT, LGBT, personal history, transgender, transition | Tagged , , , , | 4 Comments

Dating Culture Shock

Being trans and femme-attracted has made my dating pool severely smaller than it used to be and looking for love has been a cultural shock.

It’s the experience of meeting for coffee on the first date and having the conversation bent towards Everything My Date Always Wanted to Know About Being Trans and Never Had Anyone to Ask Before, or an abrupt, ‘I want your girldick in me,’ proposition and having to judge if I should trade my time searching for Ms. Right for Ms. Right Now because it’s a long motherfucking walk through the desert and just how thirsty am I today?

I had one lover like mercury: bright, fluid, and damaging to my nervous system. I was never sure if what she told me about her life was the shape she was at the moment or the shape she was being pulled to be by the gravity of her life.

Laying naked in a hotel room bed waiting for her to emerge from the bathroom, I rationalized being there by telling myself it was a one-night fling because she was married, lived on the other side of the continent, and she was just what I needed when I needed it. I counted myself lucky she only left me with a herpes scare from our fucking and not fucked with a lifelong infection.

In retrospect, I should have steered way clear of her because I had no business having any sort of entanglement, physical or emotional, a few months after my ex moved out and a few months before my transition. Having been placed in involuntary intimate solitude for over a year made me willing to trade being a notch on quicksilver’s bedpost for some physical comfort.

It was a transaction, even if neither one of us was quite sure who was buying and who was selling.

The rest of the landscape has been just as foreign to me.

There was the well-meaning friend who suggested polyamory and would I be interested in going to a meetup? A top with a boundary issue around not respecting the word stop, bottoms pretending to be tops, the other bottoms where I think we were both waiting for the other to make the first move but I’m still not sure, and dudes.

Masculine interest is an interesting counterpoint to the feminine. It’s often more direct, transparent, and dangerous. I’ve experienced dozens of creeps who’ve stared or said something to me and looked like they’d lose their shit if someone told them no. I’ve found it easier to ignore them all–potential good along with all the known bad.

One of these days I’ll learn to speak the language here. I hope.

©Heather Coldstream

I’m on Twitter @cistotrans

Please consider supporting my writing by sharing it with others with attribution and linking back or buying one of my poetry collections from the Kindle store. Thank you!

2016: Poems from a Year of Change

Uncertain: Poems About Gender Transition

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Dear Dick,

Dear Dick,

I’m sorry—I’m breaking up with you.

The past few years have made it clear I just can’t be with you any more. It’s not fair to you for me to be thinking of Pussy when we’re together.

I know you’ve tried your best to role-play her but it just doesn’t work for me. There’s no spark joy in my heart anymore. So, you have to go and I thank you for our time together.

Thrown together from before birth, ours was a complicated relationship. But I think we both knew from a young age we weren’t right for each other.

You were always popping up when you weren’t wanted and you really deserved someone who truly appreciated and wanted you around all the time. Your reputation made my life harder sometimes and let’s just say that some of your decisions were questionable; especially after you’d been drinking in your twenties.

Like all my other relationships that ended on speaking terms, I feel ambivalent. We sure had our ups and downs, didn’t we?

From houses to tents, from forests to fields, from oceans to mountains, and on planes, trains, and automobiles, we explored the world together.

Some of those adventures were exquisite, timeless, unforgettable moments of joy I still treasure. Others I really, really wish I could forget, (and just why oh why do so many of the bad ones include couches or futons, anyway?)

So, goodbye, and know that a little bit of you will live on inside of me.



©Heather Coldstream

I’m on Twitter @cistotrans

Please consider supporting my writing by sharing it with others with attribution and linking back or buying one of my poetry collections from the Kindle store. Thank you!

2016: Poems from a Year of Change

Uncertain: Poems About Gender Transition

Posted in gender transition, humor, LGBT, self-acceptance, transgender, transition | Tagged , , , , | 4 Comments

Five Years of HRT

It will be five years of continuous estrogen therapy* for me on the 6th of February 2019. Over that span of time my body has changed shape to follow ancient pathways set by evolution, my emotions have shifted like sandbars in a river, my thoughts move in different ways like light entering a medium, and I have been left with dual questions I meditate upon: did transition change my life or did I transition to change my life?

There is the physical; I have grown breasts, my skin is softer, muscle has atrophied and in some areas been replaced with fat, much of my body hair has thinned and lightened, and I am overall less angular and more round. Besides the obvious breast changes, which took about a year to accommodate in physical space before I mostly stopped banging them on things, the musculature changes have effected me the most.

Loss of muscle mass means I’m not as strong as I used to be and I have had to become more practiced at balance and force to move heavy objects. Opening jars and packaging is sometimes a study in letting go of ego and reaching for scissors and patience. My stamina and recovery time seem to have inverted, even accounting for age. Overall, its main change to my life has been to breed acceptance and gratitude for assistance when I need it.

My emotions, for so long bottled up and stored away like so much nitroglycerin waiting for a hard jostle to explode, are decanted daily for sips of feeling. Indeed, the steady background hum and clinking of emotional energy spent on bottling I worked hard to tune out has been replaced by the not-so-strange attraction of babbling brooks and ocean waves.

Where there was once a grayscale, wintry, rocky landscape suffused with much darkness and pooled black voids of anger there are now a riot of spring colors where purple iris flashes its yellow and white tongues in laughter while the cerulean sky vibrates in the warm, yellow sunlight falling upon viridescent leaves. Tears, once relegated to weeping from cracks in stolid granite rocked by un-ignorable impacts now bubble freely from reservoirs tapped by caresses or bumps of joy, sorrow, and myriad other emotions ephemeral as clouds.

My previously unassailable thoughts, which often rushed along in their certainty of shape and form, now more willingly pause and linger for probing, deconstruction, and reassembly before delivery. More emerge as hypotheses open to revision than incontrovertible facts.

I consider other people much more in my calculations, which express themselves as explorations towards multiple outcomes balancing my and others’ needs than a rigid algorithmic process towards a single conclusion tilted in my favor.

Across all of these areas I am still the same old me though. I’m still prone to clumsiness, still stubborn to ask for help, still struggle to understand what I feel at times, I still too often jump to conclusions, and I still have blind spots around being considerate and kind to other people.

But after five years I think my biggest takeaway from taking estrogen is that I continue to choose to use it and have it maintain its effects on my body and my life. I do worry about the long-term use of it with regards to things like stroke or blood clots though.

While it is for all intents and purposes a vital maintenance medicine for me, I will not physically die if I don’t take it** and like all medicines, I have judged the real, positive outcomes to be greater than the potential negative side effects.

Why? My answer is the same as the answer to my dual questions above about transition: yes, why?

* Also known as HRT or hormone replacement therapy, estrogenic therapy often includes an anti-androgen to counteract testosterone. In my case, I’ve only taken estrogen. See my post A Brief Overview of Feminizing Hormones for general information about estrogen hormone replacement therapy. I kept a weekly online journal of my changes, which you can explore by searching for the HRT tag on my blog.

** What that might do to my mental state and how that might effect my depression is an open question I’m not at all interested in exploring.

©Heather Coldstream

I’m on Twitter @cistotrans

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2016: Poems from a Year of Change

Uncertain: Poems About Gender Transition

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