This Pride Month, Rewire.News recognizes that celebrating during the pandemic will look very different for many of us, which is why we’re putting together tools of resistance and hope to help us all survive (and even thrive) Pride 2020.

As told to Tiffany Diane Tso.

I’d been wanting to get gender-affirming surgery for about a decade, but finances and insurance were always an issue due to my former undocumented status. Once I took care of the necessary steps to schedule an operation, the COVID-19 pandemic hit and further delayed and complicated the journey. Today, I can say that I survived surgery during a pandemic.

My top surgery was originally scheduled for May 22 at MedStar Franklin Square Medical Center in Maryland. Because of the lockdown orders for COVID-19, it was rescheduled for 7:30 a.m. on June 16.

Scheduling this surgery wasn’t even possible for me until recently. In 2018, I was able to adjust my immigration status, and in January 2019, I got a full-time job with decent insurance (enter Rewire.News), and the ball was set in motion.

Every part of this process was done piecemeal because of the limitations of my insurance and my physical location. My experience isn’t a blanket experience for all transgender folks seeking gender-affirming surgery. If anything, the complications that came up are out of the norm from what most folks I’ve known who have gone through this process have told me.

My unknowledgeable migrant self didn’t know much about the world of insurance since I’d never had it before, so I didn’t know the ins and outs when I first signed on to the policy. I was just elated that I would be in a financial position to afford health care. I discovered that my work’s insurance is based out of Maryland when I started looking into therapists in the summer of 2019. (I was dealing with some generalized anxiety, gender dysphoria, and emotions around recently getting papers.) I realized all the therapists in New York were out-of-network for my insurance, so I ended up dropping that search out of frustration and pushing it to the back of my mind. (Sadly, it came back around to haunt me when I started looking into surgeons later that winter.) Looking back, I would have researched more insurance options within New York, as it would’ve made this process so much easier.

That same summer, it dawned on me that if there ever was a time to put myself, my needs, and my happiness first, it was this moment. In September 2019, I started looking into what was possible for top surgery, what I would need, and if I could afford care from a doctor who was knowledgeable and experienced in this process. It felt like an impossible feat—especially after learning that before I could even set foot inside a doctor’s office for a consultation I would need to have at least one letter of support from a licensed mental health professional verifying my gender dysphoria.

That wasn’t the only hoop I had to jump through to make this happen—here’s what my journey looked like.

With my COVID-19 test results

Step 1: Get a letter of support.

My partner is a longtime social worker in New York and has had the honor of supporting many trans folks through this process. She pointed me in the direction of a few clinics and hospitals in the state that provide services for trans folks, including medical visits and top surgery letters. I made a number of appointments and by early January 2020, I was able to obtain a physical and the letter I needed to get a consultation.

Step 2: Find a doctor. (Normally people have a doctor in mind before they get the physical and letter).

The last two weeks of December, I started digging into my policy, searching for any options available to me. Once I realized New York providers were out of the question, I ended up looking into Maryland (it took me forever to even consider looking outside of my state) and found the only doctor that performed gender-affirming surgeries (both top and bottom) in the region: Dr. Gabriel Del Corral.

I immediately rang the office, not knowing what to expect, crossing my fingers that my insurance was accepted. I was trying to keep it together with every ring, and after the call I realized the light at the end of the tunnel was now closer than ever. They accepted my insurance! Once they received my letter of support, they could schedule me for a consultation.

There was one small snafu: The practice had only ever performed this type of surgery on patients who were on testosterone for at least six months to a year. I’m not on testosterone (by choice), and my insurance doesn’t require me to be on hormones to have the surgery, so I had to fight the practice on that a little. Most practices and insurance companies (depending on the state) are moving away from requiring their patients to be on testosterone, as they’re seeing more folks who don’t identify as trans men wanting to get top surgery (perfect for nonbinary folks like me).

After jumping through that obstacle, I called my insurance to figure out the costs. I think I made about seven phone calls to get a clear answer: I would need to pay the deductible first (about $1,000), $400 for the anesthesiologist’s fee, and any additional fees for any other doctors that may be present at the surgery. After that, insurance would kick in and supposedly pay the remainder.

Step 3: Have a consultation with Dr. Del Corral on February 21. 

This was a very surreal experience and an extremely vulnerable one, as you need to remove your clothing and expose a part of your body that you’re probably at war with to be examined by the doctor (and photographed by an assistant). I was really taken aback at how tender and thoughtful the doctor (a young man of color) was. Throughout the 30- to 40-minute visit, he told me about what type of procedure would be best for me (double incision), walked me through what the operation day would look like and what I should do to prepare for the surgery, and used my correct pronouns the entire time. (This may sound like a low bar, but you’d be surprised in the medical world.)

The doctor was kind in his approach, didn’t make assumptions, and made space for every question I had. I left my visit feeling seen, safe, considered, and actually cared for—things that all trans and queer people deserve to feel in any setting, especially one so vulnerable and loaded.

Step 4: Schedule the operation for May 22.

I later followed up by phone with the surgery coordinator, who scheduled my operation for May 22. By the end of February, everything was looking positive, and I was feeling all the confidence in the world. Then COVID-19 hit New York.

I had been keeping an eye on the situation since December 2019, when I first heard about it. Because my partner is immunocompromised, we decided we’d temporarily leave New York City if the situation got worse. And it did get worse.

On March 18, I celebrated my birthday in quarantine, freaking out about my safety, my partner’s safety, the surgery, and the certainty of having to leave New York. I also launched a GoFundMe to help offset the costs of the surgery, including aftercare costs (medication, compression binders, and food) and travel costs from having to go out of state for it. I knew that when I went to Maryland for the operation, I’d have to stay for at least ten days to heal and for a follow-up appointment to remove bandages and bolsters. I was able to fundraise about $4,600 of my $5,000 goal by the end of May.

On the night of March 20, we packed some overnight bags and hopped in a car with my partner’s sister and her family and headed to Southampton, New Jersey, where my in-laws live. After almost two months of sheltering in place in Southampton, my doctor’s office called to let me know my surgery had to be postponed. (I had called a few times before to see if there’d be any date changes, but no one had answers then.) I had just come back from a trip to Maryland to get mandatory pre-operative blood work and a physical done when I heard the voicemail—it was crushing news. I called back immediately, fearing that I would have to wait another two or three months for surgery.

Step 5: Reschedule the operation for June 16.

The earliest reschedule date I was offered was July 6, which I begrudgingly took and asked to be contacted if anything earlier opened up. Half-an-hour later, I got an email saying June 16 was open—I took that date and ran like the wind with it! The later date meant I would have to return to Maryland for another preoperative physical, since my doctor’s office informed me that physicals are only good for 30 days and bloodwork is good for 90 days. I would also need to get a COVID-19 test 72 hours before surgery, meaning a slightly longer stay in Maryland than originally expected. But it was all worth it.

Our rental car packed with all of my aftercare supplies

Step 6: Get surgery on June 16.

My partner and I rented a car and drove to Maryland on the Friday before my June 16 operation for my COVID-19 test, which came back negative (yay!). Then, we quarantined for three days in a cute little Airbnb in Baltimore.

On the day leading up to the surgery, we ordered some bougie Argentinian food to enjoy, since I wasn’t going to be able to eat after a certain hour that night. I ate steak, watched movies, and tried to relax as much as possible. This was my first surgery, so I was feeling pretty terrified that it would hurt, and also because COVID-19 is still lurking. I also wished I could be close to my family. I felt hopeful, but it was hard to feel positive about everything.

This summer, I’m supposed to be going through the process of lifting the restrictions of my green card so I can stay for ten years, which means my partner and I have to supply two years of proof of our relationship. Compiling that has been stressful and time-consuming, especially since a lot of our proof is in New York City. I think the theme of “proof” this summer has been one that has become tired and annoying at this point. Having been undocumented and having to prove a relationship to validate legal existence, and being trans and needing to have a licensed professional prove your transness—that’s kind of what’s taking up a lot of the space in my mind.

On the morning of the surgery, we had to be at the hospital by 5:30 a.m., when they opened up. That morning and the night before, I had to rinse my chest area with an anti-bacterial wash called Hibiclens.

The mountain of aftercare supplies I needed to get before the surgery

Everybody at the hospital is really nice, and I learned that I am allowed to have a support person in the room with me before and after the operation. When I met with Dr. Del Corral, he told me that due to a change in weight since the last time he saw me, I would be getting a bilateral mastectomy with no drains, which I had never heard of before. It was jarring to get this news 30 minutes before surgery, but the doctor seems trustworthy, so I went along with it.

I probably saw four different doctors before the operation, each one explaining different parts of the procedure. They were all really thorough, so there were no other surprises along the way.

When I got in the operation room, it’s the first time I’ve ever seen one in real life. It’s very bright with lots of shiny metal tools. In my hospital gown, the staff prepped me, and stretched my arms out like I’m on a cross. It was a little creepy and scary having all these people looking at you.

Right before the anesthesia knocked me out, I remember my last words to some of the doctors in the room being, “Can you please use my correct pronouns?” (Dr. Del Corral always said they/them, but others were using she/her.)

The operation took about 90 minutes, and I woke up bandaged in a recovery room to a nurse with short, platinum blonde hair—she was incredibly sweet and a Scorpio. We had a nice conversation, and she let me know that I’d be able to see my partner in the next room, a sort of post-recovery room. We were told that the operation was a success, and we left the hospital at around 10:45 a.m. with a thorough packet of information on what to expect and plan for over the next few days post-surgery. “Come back on Tuesday to remove the bindings and the bolsters.”

The first thing I did afterward was pick up and eat pie—because pie fixes everything. The pain didn’t really kick in until later at night, once the anesthesia and the cocktail of painkillers they gave me was wearing off. I think they gave me a little bit of fentanyl. The pain was usually the worst at night.

Passed out post-surgery

Step 7: Go back for a post-op appointment a week later.

My post-op appointment went well. I didn’t have any complications, like seromas (fluid build up), which are common with these surgeries. I also have almost no bruises—the least I’ve seen based on other folks’ experiences. I am told I have to go back on July 20, which I was unaware of, to get the final tape and stitches removed.

The pain has been manageable, but the new daily routine of changing my gauze has me literally in tears and shaking. I have to remove the surgical tape that is holding gauze and a lubricated square on top of the grafts. The tape was super stuck on and placed over some incisions, so pulling it off and replacing it was a nightmare that took over an hour and two people. As a generally queasy person, having to do that while looking at tender, raw skin and cuts and blood was enough to make me irrationally regret that I even went through with this to begin with. But those feelings subsided once the tape finally came off.

Chest reveal

Step 8: Reveal my scars during Pride Month.

My partner has been with me every step of this journey, and I’m incredibly grateful for everything she’s done. After surgery, I couldn’t even take off my own pants—it was a very intimate and humbling experience. I know that there are folks who undergo this type of surgery without much or any support, so I count myself lucky.

My community was also instrumental in making all of this possible. Without the donations and people sharing the GoFundMe, I definitely would not have been able to afford this. I also felt so privileged to have extended family nearby, to be able to weather out the pandemic at my in-laws’ home. I can’t imagine moving through these moments if it wasn’t for my safety net.

And now for the hard part. I was never one for a public chest reveal, but it felt somewhat symbolic to get my scars during this particular Pride Month. After surgery, my mom told me she thought I was really brave. That meant a lot coming from her, especially after so many years of struggling to explain my rationale with her. It’s hard for me to believe—as I see myself as mostly full of shame and apologies—but I suppose I’ve been brave all of my life on the inside.

Now it feels like I finally have an outer shell to match all the inner turmoil. “Pride” looks different for everyone—I’m still learning to accept myself. All parts. Even the ones that hurt to admit to myself in the dead of night. I’m grateful to see a familiar reflection now. Still working on the heart.