BALLS Page 16

  “So why can’t I go home?” I asked. Mom even made a plea as a nurse, hoping that might sway her. Nope.

  “I want you here overnight,” she said. “Two nights is protocol but since you’re young and healthy, I’ll let you go home tomorrow if all goes well.”

  Fine. How bad could one night be? Doped up on pain meds, I figured I’d sleep right through. Ha. Was I in for a rude awakening—in more ways than one! My room was right outside the nurses’ station. So between their voices, the constant beeping of hospital equipment, and beleaguered cries from patients in desperate need of ice chips, I would’ve had better luck trying to sleep through a prison riot. Not to mention every time I did manage to doze off I was awakened by a medical student checking my vital signs (yes, I’m still alive!) or worse, attempting to draw blood.

  When my doctor showed up at 8:00 a.m., I was practically homicidal. She flipped through my chart and told me everything looked great. A few hours later, she finally let me go home. And while I was psyched to put that hospital stay in my rearview, I knew it was only the beginning.

  “BOTTOM SURGERY”

  Spring 1998

  It’s a lot easier to turn a penis into a vagina than a vagina into a penis. Which might explain why more transgender women choose to undergo surgery: One or two operations can yield very good results and run maybe $25,000 or less. Building a penis is a lot more complex and way more costly. As many doctors and my mom have put it, it’s a lot harder to add than it is to subtract.

  Phalloplasty, as it is called, requires multiple procedures with lengthy recovery times and the potential for numerous complications. Add a six-figure price tag for what I like to call the “deluxe model,” and it’s no wonder “bottom surgery” is not as popular with transgender men. Some choose to stop after the mastectomy and forgo it altogether. Others pass on phalloplasty and opt instead for a less complicated, less expensive surgery called metoidioplasty. This involves taking the clitoris, which has been slightly enlarged due to testosterone, and releasing or untethering it so it hangs like a penis. If size matters, this is probably not the surgery for you.

  I knew I wanted bottom surgery and, based solely on the medical literature I’d dug up, a metoidioplasty wasn’t going to cut it for me. I was born both a Taurus and a perfectionist, which meant I was willing to go through whatever it would take to get myself the closest thing to a fully functioning biological penis. I wanted to pee standing up. I wanted to be able to have intercourse—to feel what it’s like to be inside a woman. I wanted all those things that most genetic men take for granted because they were born with what I lacked.

  What I didn’t know was that finding the right doctor would be so difficult. When I began my search back in late 1996, there were only a handful of surgeons that performed phalloplasties in the United States and Canada. The Internet was relatively new so there was very little research one could do online. I relied on information from gender clinics, Bet’s knowledge, word of mouth from my support group, and eventually consultations with the doctors themselves. The most well-known surgeon in the field at the time was Dr. Donald Laub. Based out of Stanford in Palo Alto, California, he was a pioneer in gender reassignment surgery, inventing and evolving procedures since the 1970s. There was a doctor on the East Coast who was newer to the field and was adopting Dr. Laub’s technique, but when I mentioned him to my support group, I heard only bad reviews. Two of the guys told me they’d gone to his clinic for consultations and were treated more like dollar signs than people. Another member said he’d also heard that from someone else. A fourth guy said he knew someone personally who’d had his surgery done by this doctor and was now seeing Dr. Laub to try to “fix it.”

  Yikes!

  They all said if I was going for the deluxe model, Laub was the best choice. I asked them about the Canadian surgeon I’d read about and received a resounding STAY AWAY.

  I saw Bet that week and told her of my progress. She said she’d heard good things about Dr. Laub too and also told me about a surgeon in Florida who was doing similar work. Since Florida was a lot closer than California, I decided to go there first, and my mom was happy to join me.

  We were at thirty thousand feet en route to the Sunshine State, and I was compiling a list of questions for the doctor.

  “Ask him how many penises he’s made,” Mom said. “And tell him you want to see pictures.” Our conversation had become so matter-of-fact that she seemed to have forgotten what the subject matter was. And that we were surrounded by a plane full of people.

  “A little louder, Mom. I don’t think the pilot heard you.”

  “Lemme see what you have,” she said, reaching for my notepad.

  “Okay, hold on a sec.” I looked over my list:

  • How many phalloplasties have you done?

  • How many with microsurgery?

  • Can I see pictures? Talk to one of your patients?

  • How big will my penis be?

  • Do you create the balls—testicles—at the same time?

  • How many surgeries will it take to complete?

  • Does insurance cover any of them?

  • What are the risks?

  • What’s the recovery time like?

  • How will I achieve an erection?

  • Will I be able to have an orgasm?

  I almost didn’t write that last one down. I mean it’s not really something you want to ask in front of your mother. But doctors tend to rush you out and I was afraid I’d forget to ask if I didn’t have it on paper in front of me.

  Before I got to ask the doctor any questions, I had to answer my share. The form I was given to fill out in the waiting room was extensive, but nothing like the phonebook-size packet I was still working on for my upcoming appointment with Dr. Laub.

  Once the forms were completed, we were led to a nondescript examination room that was in keeping with the vibe of the rest of the office: very clinical with no personality whatsoever. Within a few minutes I discovered the same could be said for the doctor. He was in his late forties, with a husky build and an arrogance that easily overshadowed it. Worse, there was no compassion. He never smiled, and spoke to me about the surgery as if he were a contractor talking to me about my kitchen renovation: “It’ll be a nuisance, but if you want it done, you’re just gonna have to suffer through it.”

  Also disturbing, I couldn’t get a straight answer from him on how many phalloplasties he’d performed (somewhere between nine and twenty), and he seemed insulted by the fact that I was asking questions. He was reluctant to show me photos but eventually broke out an album of before and after shots. I was horrified by most of them—even what he deemed to be the “good penises.” I knew the surgery was far from perfected, but these penises didn’t seem to have much shape to them, let alone well-defined heads. They looked like long blobs and most of them were way too big. I asked if you could pee through them and he said no.

  That’s when Mom started asking questions and we discovered that he had only a handful of “deluxe model” surgeries under his belt.

  “That procedure requires a skin graft to extend the urethra to enable you to pee standing up,” he warned. “I’d need to remove all the skin from your inner forearm.”

  I gulped, “What kind of scar would that leave me with?”

  He said flatly, “You’ll want to wear long sleeves.”

  I asked to see photos of a forearm after surgery. He showed us a picture of one that looked like it had been severely burned in a fire from the wrist to the elbow. I turned to my mom, whose jaw had dropped, and turned back to the doctor.

  “That’s what my arm will look like for the rest of my life?”

  His response was almost as disturbing as the photo: “Do you want a penis or not?”

  That sealed my decision. This dick would not be making my dick. It might be one thing if he created the best penises in the world, but even then I wasn’t so sure. This wasn’t a “one and done” procedure like my hysterectomy. I’d be in
for several surgeries over a period of two years or more. I needed a doctor that I could feel comfortable with. And he wasn’t it.

  On the way back to the airport Mom tried to make excuses for his horrible bedside manner. Having been an OR nurse, she told me a lot of doctors, especially the skilled ones, are arrogant. I looked at her with my trademark raised eyebrow and she relented. “You’re right, Shtine, he was a prick.”

  With Florida out, we pinned our hopes on Dr. Laub, and soon Mom, Jill, and I were boarding a plane to San Francisco. Since none of us had ever been there before, we decided to turn this surgical consult into a mini family vacation. As Jill and Mom compared advice from Fodor and Frommer, I tried to take my mind off all the “what ifs” in my head: What if Dr. Laub was also arrogant and insensitive? What if his album of penises didn’t look any better? What if he also told me my forearm would look like a burn victim? Then what would I do?

  My fears stayed with me throughout the afternoon as we explored San Francisco. Riding the glass elevator up to our hotel room, I couldn’t tell if the anxiety I had was from looking down 150 feet or looking ahead to my meeting with Dr. Laub. I went over my list of questions one more time before bed and tested out the microcassette recorder I had bought for the occasion. There was going be a lot of information to take in, and his coordinator would only allow us half an hour. I argued for more time, reminding her that I was flying across the country just to meet with him, but she wouldn’t budge. I’d had three conversations with her, and so far I was not a fan.

  The next day as we approached the clinic in Palo Alto, a calm washed over me. Situated in a beautifully landscaped courtyard surrounded by all kinds of plants, flowers, and benches, it was the exact opposite of the utilitarian office building in Florida. The medical suite looked like a California bungalow—stucco with terra-cotta shingles. A woman whose voice I recognized from my previous phone calls greeted us in the courtyard. She was friendly but all business, and after a quick tour of the grounds, escorted us inside.

  While we waited, I examined all the framed awards and photos of Dr. Donald Laub covering the walls. He was smiling in every shot and looked like a warm, kind-hearted man. In some of the photos, he posed with children from around the world who suffered from cleft lip and palate deformities. Turns out Dr. Laub had made it his mission to travel to underdeveloped countries and provide life-changing plastic surgeries to tens of thousands of people in need, free of charge.

  I was blown away. Here I was thinking he just made penises and vaginas for a living. This man wasn’t just a brilliant surgeon; he was a saint. A humanitarian. I had a good feeling about him and breathed a sigh of relief as we headed to his office, which felt more like a cozy in-home library.

  Behind an elegant yet unassuming desk sat the pioneer of gender reassignment surgery, surprisingly in light blue scrubs. His hair was tousled as though he had just pulled off the matching surgical cap and rushed over from the OR, knowing he was late for our appointment. He looked to be in his early sixties, and when he stood up to greet us with a handshake and warm smile, his eyes actually twinkled. I remember thinking that with a fake white beard and padded red suit he’d make a great Santa. He motioned for us to have a seat on the other side of his desk and immediately acknowledged our cross-country journey as though he were humbled by it. I liked him right away and knew I’d feel comfortable asking him all the questions on my list. Anxious to get down to business, I pulled out my cassette recorder and asked if he minded if I taped our session, telling him I knew we only had a half hour and I wanted to make sure I didn’t forget anything. He said he didn’t mind and that I could certainly have more of his time if I needed it.

  We spent more than an hour together discussing the options for surgery. We flipped through photos of penises Dr. Laub had created and noted some were definitely better looking than others. He said when it came to the quality of results, a lot depended on patient factors like what their skin was like, if they followed instructions for after-care, and if they smoked or were overweight. Most of the penises I saw were not deluxe models, and Dr. Laub did not shrink from that fact. He said that procedure was still relatively new—not to mention extremely complex and very expensive—so very few patients opted to go that far. I told him that I planned to, and asked about the skin graft from the forearm. He told me his method would not leave me looking like a burn victim; instead of just taking the skin as is, he would insert a tissue expander into my forearm and gradually fill it with fluid until my arm expanded enough to provide the amount of skin needed to create the urethral extension. He likened the process to how the skin stretches during pregnancy. While I’d have a noticeable scar up my arm from the sutures, it would be nowhere near as frightening as what I saw in the Florida doctor’s photo book of horrors.

  Dr. Laub cautioned that there are often complications with urethroplasties, mainly infections due to blockages most often caused by hair growth. Apparently when a skin graft is extracted, the hair follicles go with it and hair continues to grow. He took out a red Sharpie and drew an outline on my inner forearm, showing me the large area where I’d need to have six months to a year of electrolysis before he would consider performing the surgery.

  My Armo heritage screws me again!

  Before I even had a moment to let that sink in, he added that if I wanted balls, tissue expanders would also need to be inserted into my labia and expanded until they were large enough to hold silicone testicular implants. The thought of that made me want to faint, so I moved on to the erection question. Dr. Laub said there were two types of permanent implants: a rigid but bendable rod or a pump device that could be inflated on demand. He quickly added that there is a high risk of these implants eroding through the skin due to lack of sensation down there. This is why patients often choose to forego implants and use a removable rod that can be inserted into the penis just prior to intercourse.

  I was beginning to understand why so few people opt for this surgery, and Dr. Laub must have seen it on my face. He had accurately judged me as a perfectionist and wanted to manage my expectations. He quickly emphasized that while the surgery was not perfect, his surgical team was making advances with each procedure and there might be new techniques developed by the time I was ready. He said I was a good candidate but that I should take some time to process everything we discussed. It was a lot to think about for sure. I truly felt like I was going to hurl.

  He looked at me and smiled. “Chris, there are people out there who need surgery to stay alive. You’re coming out here to get a penis. You’re lucky. Remember that.”

  I wasn’t feeling very lucky. But I did get his point.

  On the ride back to the hotel, Mom and I agreed on two things:

  1. The amount and nature of the surgery I’d have to go through was frightening.

  2. Dr. Laub was the man for the job.

  She asked me if I was sure I wanted to go through with it. As terrified as I was of the pain, potential complications, and unknown aesthetics, the answer was still, without hesitation, “Yes.”

  THE ART (AND PAIN) OF HAIR REMOVAL

  May 1998

  “You’ll love her, Eddie,” Straubs promised me, “She’s so sweet and she’s really good—and fast.”

  My friend “Straubs” was setting me up. With her electrologist.

  Her name was Deborah and according to Straubs she was both happy and eager to help me. So off I went to Newbury Electrology. As I tried to get comfortable on a lumpy vintage chaise, the young woman seated on the opposite side of the waiting room stole a glance at me and quickly buried her face back in her magazine. Trust me. It’s way more embarrassing for me to be here than you. To pass the time, I began hypothesizing what she was having done. She didn’t seem that hairy but I didn’t get a good look at her face. Upper lip maybe? Was a mustache the reason she was hiding behind that outdated People? Then it occurred to me if I was imagining what she was doing here, she was probably wondering the same thing about me. Ha! Good luck with that one.<
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  After a few minutes the door to the adjoining room opened and Deborah appeared wearing a white lab coat. She was around 5’1” with fair skin and short dark hair tucked behind her ears. The young woman dropped the magazine she was fake-reading and bolted inside. Deborah turned to me and with a warm smile said, “I’ll be right with you, Chris.”

  Straubs was right. I loved Deborah. She was professional but caring and compassionate. She listened intently as I explained the gravity of my particular hair removal; that it wasn’t just for aesthetics. That the skin she would be treating would be used to form the extension to my urethra and if any hair grew inside it, it could cause blockages and infections. She asked a few questions only as they pertained to her job and I answered them, giving her a bit more information than necessary because (1) I could tell she was curious and didn’t want to overstep her bounds and (2) as far as I was concerned, Deborah was now part of “Team Edwards,” so I wanted her to have all the information she’d need to help my transformation be successful. Plus I just tend to over-share.

  I rolled up my sleeve and showed her the seven-inch by three-inch area on the underside of my forearm that I’d marked off. She explained the cycle of hair growth and how over time electrolysis works to permanently destroy the follicles’ ability to grow hair. To get the results I needed she suggested thirty- to sixty-minute sessions two to three times a week.

  Shit. At eighty bucks an hour, this was gonna add up.

  Deborah showed me the machine and the needle she’d be using and then discussed the current strength she felt would be most effective. The trick is finding the balance between pain and efficacy; you want the current strong enough so that the hair can easily be removed with one zap but not so strong that the pain is unbearable. She quickly zeroed in on the right setting, but it was still pretty painful. The machine also made a clicking sound with each zap, which I found unnerving. I began to count the clicks in my head—most thirty-minute sessions getting into the hundreds—and then I’d lose track. Deborah was fast. Zap zap zap, pluck pluck pluck. She covered a lot of ground. After every session, my arm was covered with raised red dots. I wore long sleeves quite a bit that summer.