“Fuck,” Lucia muttered as we walked into the hospital. I followed her gaze to the opposite side of the lobby, where there hung a cross bearing a White Jesus. The place was called Mercy, so I guess I should’ve known it was a religious hospital, but I hadn’t thought about it. Technically I should’ve had my pre-op done there, but with the way things turned out, the day of my mastectomy was my first time there. Everything leading up to this day had been so convoluted, so unnecessarily difficult that a little religion thrown in at the end wasn’t even the worst of it. But Lucia, raised in a mostly-Catholic country by atheist parents, was more vehemently opposed to religion than I was. I squeezed her hand as we headed to reception. The White woman at the desk directed us to intake, where we sat in a small waiting area in front of a row of offices.
Two minutes later, we were called into the first office and greeted by a smiling White woman who had me sign a lot of paperwork. Here is the HIPAA consent, here is where you consent to CPR if anything should go wrong on the operating table, here is an indemnity waiver. She looked me up and down and hit a few keys. “I’m putting you down as Race 1, Ethnicity 2. Is there a religious affiliation you’d like me to register today?”
Lucia and I looked at each other. “Do you think that’s a good score?” I asked her.
She wasn’t amused. “What’s Race 1, Ethnicity 2?”
“Race 1 is White, Ethnicity 2 is non-Hispanic.” Of course. The nurse was putting labels with my information on all my paperwork. I don’t know what I’d expected her to say. It would be too much work to go through the “I’m-actually-Latinx” thing with this woman, so I didn’t.(1) I declined to list a religious affiliation—that, too, would’ve been complicated: I have Jewish heritage, was raised Christian, and don’t believe in God— and busied myself signing all the forms the woman thrust at me.
“Kiwi and pineapple.”
“What happens when you have them?” “My lips swell and my mouth itches.”
“You want to keep an eye out for that. It can turn into a latex allergy later. Any allergies to medications? No? Okay.” When all the papers had been signed, we moved to the next office, where another White nurse inserted an IV and drew blood. It was thick and dark; the tube took forever to fill, prompting the nurse to say I was probably dehydrated. I stared at the floor as the nurse took my vitals. I was nearing twelve hours without food. I normally need to eat every four to five hours and am emotionally incontinent when my blood sugar is low. Lucia knew this, so she did the talking for me as much as possible.
A Black nurse named Debbie came in and handed me a cup for a urinalysis. She looked me up and down, looked at the surgery I was getting, and asked how she should refer to me. The welcome, tender question made me burst into tears. Debbie looked concerned. “It’s really fine,” Lucia said. “Just say Emerson, it’s easier.” (2) Debbie nodded and disappeared. I ducked into the bathroom to provide a sample and came back, swaying with dizziness, to my chair by Lucia.
We made our way through two more offices before I was asked to change into a hospital gown and given a bed. It was freezing, and after a short while of motionlessness, I couldn’t feel my toes. Every time a nurse came to take blood, they asked my name and birthdate, just to make sure I was the right person. They made me look at the tubes of blood to make sure they’d written the right thing on them. “There are so many more things we have to check for and match these days,” one nurse said to me. “It’s not just blood type and positive or negative anymore like you learned in school.” I like biology, and if I’d been in my right mind I’d have asked more questions, but I just nodded at her and asked for another blanket.
The only other nurse whose name I remember was the last one, who wheeled me into the holding room right before the surgery. The others had been calling her Annie, but her name tag read my deadname and she looked Latina. When she introduced herself, Lucia and I exchanged bemused smiles over the coincidence. “It’s a sign,” I said. She smiled without parting her lips and wore blue gloves. She took charge of my bed and we walked a few steps only to stop. “This is the place where people usually kiss—or hug,” she added quickly.
I was so bundled in blankets I couldn’t move. Lucia kissed my forehead, said, “See you on the other side,” and stepped back. Annie pushed me through double doors into the holding room, where it was even colder. I met the surgeon’s assistant, a young woman, maybe Filipina; she wore a mask but had kind eyes. Then the anesthesiologist came in, a tall White man with a loud voice. He asked if I was allergic to any medicines. “Not that I know of,” I said.
He looked at my chart. “This kiwi/pineapple allergy can turn into a latex allergy, you know.”
“I know.” My surgeon still hadn’t shown. The nurse assured me she was in the building. I wondered vaguely if she’d hit traffic. I was so cold and hungry my thinking felt slow, disjointed.
Finally Dr. V came in. She had her hair pulled back in a tight, impeccable ponytail and, having forgotten since our first appointment what she looked like, I was again struck by how beautiful she was. I’d chosen her because of her background. She grew up in India studying dance. She studied ballet and modern dance for twenty years and then decided to become a surgeon in the US. She had an artistic side and a scientific side. I could relate to that. And anyone who chooses two fields requiring precision and control has talent.
Once she came in, they quickly wheeled me into the operating room. It was smaller than I’d expected, and the lights were blinding. The assistant and anesthesiologist helped me move from the bed to the narrow table. “Center yourself on it. Then bring your arms up.” I did and was buckled into the arm supports. “So you don’t move or jostle us while you’re out.” Then the anesthesiologist came around to my IV side and pushed a syringe full of something clear into my arm.
Some days I forget there was ever a first part of my life in which I was someone else, a girl. Some days it’s like I’ve always been this way, flat-chested, with mannish mannerisms and a headstrong personality. But this is what I’ve grown into. What I grew up as was someone else. A person who no longer exists.
I know there is much to be thankful for about this body. It generally follows my orders. I do not have an immune disorder, my blood coexists happily with my cells, I do not require chemotherapy. I can run, skip, walk and jump to my heart’s content if I have an inhaler. But even so, for the first twenty-odd years of my life, I was largely unhappy, misunderstood and discomforted. I doggedly repeated inside my head, “You don’t have to be that kind of girl. You don’t have to be that kind of girl.” What kind of girl? Any kind giving me reservations about my gender. Didn’t want to be a pink princess kind of girl? Don’t worry, you don’t have to, said my brain. Don’t want to be a girl with crushes on boys? Don’t worry, you don’t have to be that kind of girl.
But I spent so long telling myself I didn’t have to be any particular kind of girl that I didn’t stop to think about what I did want to be. I was pretty sure I didn’t want to be a man, but I didn’t know there were other options. So I just kept telling myself, “Don’t worry, you can be whoever you want to be,” and felt all the worse for allowing people to see me as a girl.
I was in the shower (3) when it came to me: “regular” people don’t spend time wondering if they’re trans. It hit me in waves, turning my stomach and making my breath come faster. Why would you be asking yourself this question if you weren’t trans? Exactly. I cut the water off and stood blinking in the sudden silence. “Fuck,” I whispered, pulling aside the yellow-duckie shower curtain and stepping onto the mat. “Fuck, fuck, fuck,” as I grabbed my towel and wrapped it around my waist. “Oh no, oh no, please no...” I breathed, leaving the bathroom and going to my bed. I sat down, hair still dripping, and put my head between my knees. Staring at the tile floor between my feet, I let the thought settle. I am trans. I am a transgender person. Beyond that, it was hard to think. Fuck, fuck, fuck. There was no relaxation, no relief at finally having figured out the question I’d been wrestling with for, really, my whole life.
I was nineteen, in the fall semester of my middle (4) year of undergrad. I had a girlfriend who identified as lesbian. What would I tell her? I’d already come out as bisexual (age thirteen) and later gay (age eighteen). I was heavily involved in campus social life; many people knew me or knew of me. I’d have to reintroduce myself to the entire community, not to mention my parents. And my brothers. My baby brother had just been born the previous summer; if I moved quickly, he’d never learn my birth name.
I had fought against the truth without knowing it for so long. Now I had it right there in front of me. And it hurt. I would have to do so much work. I would have to ask everyone to call me by different pronouns, and graciously bear the errors people would inevitably make. And the hassle to change my name on all my legal documents. Was I really signing up for all this grief? I suppose I had a choice. I could have remained—outwardly anyway—a girl. But although I was terrified of my newfound knowledge, I felt so quiet inside. The questions I’d always carried and the discomfort I’d had with myself were quelled, like a child who falls asleep so deeply, so suddenly.
I got my first binder not long after. It was cheap, bought off an Asian website I couldn’t understand; just converting the measurements I’d taken of my chest brought me a week of hemming and hawing over the sizing. The Internet had recommended this site to me, said it at least wasn’t marketed toward cisgender men, the way “compression shirts” often are. I bought one in a half-tank style; it had Velcro on one side. I’d read I shouldn’t force my ribs into something tight right away, should give my body time to adapt, so I figured starting with an adjustable binder would be apt.
Forums and threads I’d been scouring told me I should work up to an eight-hour day of binding, I should never exercise in it, I should always have it loose enough to take a deep breath, and I should never sleep in it. (5) The day it arrived, I immediately took the package back to my room and ripped it open. The binder was stark white, with black mesh lining the front. The patch of Velcro was large, but not as strong as I’d thought it would be. I could tell it’d be itchy if my skin were exposed to it. I stripped off my t-shirt and slid into the binder right arm first. I emptied my lungs, tucked in my gut and closed the Velcro under my left armpit. Once anchored, I inhaled slowly. It was tight; my ribs couldn’t relax. But the front of my chest was flat, or nearly so. I opened the Velcro and filled my lungs, then anchored the binder around the circumference of my air-filled chest. When I exhaled, the cinch was looser, not painful. I can stand this, I thought. I stood before the full-length mirror on the exterior of my closet door. The binder stopped just u