Trans-Scribed – 
Okay babes, let’s talk physical transition. One aspect specifically, though: Surgery; the cleaving dream in sight of fruition.
Trans and nonbinary folk sometimes find themselves stacked with a dual burden – not only are we subject to dysphoria, we also often need surgeries that are life-saving. Let’s be clear! These are not “elective surgeries”. That is not up for debate. Surgeries save trans and nonbinary people, period.
That need is a toiling effervescence. Most often, people in need of surgeries for transition and/or affirmation are tasked entirely (by nature of their need) with maneuvering their way through the bulwark gatekeeping of anti-trans and/or genuine ignorance so ubiquitous in the medical field. Many of us, alienated from the social security of performing expected normative behavior due to our refusal or exhaustion, do not have the support that cisgender individuals do. It’s a cis world and we’re just trans in it, apparently.
So we must also become our own advocates, and medical experts; insurance navigators and community organizers. If you’re fortunate enough to be trans in a place where places like Portland’s Q Center, Cascade Aids Project, and even Outside-In exist, then there’s a modicum of assistance to be found. A trace. A raft in a rolling ocean. In the end, even with an understanding doctor, a compassionate therapist, and a stalwart community, it can be extremely difficult to fulfill your dream.
Especially if you don’t have insurance. And it cannot be understated how many trans people are screwed out of having insurance because they make just too much to qualify for low-income health plans, and nowhere approaching the amount it takes to consistently pay for a private health insurance plan that would actually pay for your surgery. It’s certainly not an impossible situation – poor people get surgery frequently… just with years of delay.
I fought for my surgery for a long time. At first, I made too much for low-income insurance. I worked my ass off at a terrible job that started punishing my body more than it could ever hope to heal in time to work again, and I never had any trace of savings to my name. There wasn’t room for more insurance – I stopped driving because car insurance alone was getting too expensive.
My mobility limited and my work atrociously debilitating, I also found myself living in a home where hoarding, drug addiction, abuse, and eventually even death, were formidable presences. In the end, it was houselessness and lack of access to stable work that found me in a place where I qualified for healthcare. I finally had access to hormones and a primary care physician! There was hope. I was an impoverished, houseless, PTSD-infused mess, and it was in that position that for the first time there was a semblance of security.
That’s where healthcare for trans folk is right now. And when you do manage to grasp yourself some access to basic healthcare (even from the pit of poverty), it’s then the fucking circus begins. Before getting my surgery, I ran this goddamned gambit: 3 doctors, 4 therapists, a surgeon, and to top it all off ~ two denials through insurance that I had to appeal with the help of the AMAZING people at Cascade Aids Project (seriously, please take advantage of CAP’s insurance navigators if you’re in Portland – I wish I had found that resource a long time ago).
Not everyone has such an indirect path. Others, many others, are far less fortunate than I in their treading. Crowdfunding for surgery has become a tool vital to the stories of many people in transition, and drag is still how many in the family pay their way.
There’s one more thing I want to say, as a setup for the next installment. Getting surgery is not the end. Even if you know exactly what you want, everything seems to take too long and is too fast at the end. You might not get exactly your desire ~ which can be really disheartening. It was for me, and really, I’m still in that space. Revisions might be needed, and there’s always the matter of other body-oriented dysphorias.
My greatest tip for fellow trans and enby babes out there: be patient with yourself. Have patience with your body. Know that you are on your way, whichever way that is, and each step – each ridiculous fucking hoop set jumped through – is getting you closer.
You’re getting closer.