I received my new passport today, having followed the guidelines written up at the National Committee for Transgender Equality (NCTE) website. It’s worth noting that these procedures cannot be found at the passport office’s website, http://travel.state.gov/passport/, so if you’re not using trans-friendly resources, I don’t know how trans* folk are supposed to submit the proper paperwork.

So I sent a cover letter in case the clerk working on my application didn’t understand:

Following the guidelines published by the NCTE (National Committee for Transgender Equality), which detail the somewhat unwritten rules of your office regarding passports for transgender people, I’m sending your office my paperwork to get a new passport with my new name and sex. I enclose the following:

  • Form DS-82
  • re-issued state birth certificate
  • driver’s license
  • notarized letter from my surgeon
  • certified copy of the court order granting name and gender change
  • current passport
  • 2 passport photographs
  • check for $75

Please reissue my passport using my new image, new name, and new sex. If I am missing any documentation, I trust you’ll contact me.

I felt it was utterly critical to have a new passport — even though I could get a new name and a new photo, but there is no way to change the gender marker without a surgeon’s letter. And I cannot fathom traveling around the world looking the way I do with an “M” on my passport. I know the government wants good, positive identification, and I don’t have any problems with that general philosophy, but no one knows what’s in any traveler’s pants, and in this respect, the requirement to show a surgeon’s letter is a little like the crazy bathroom rules that propose some sort of genital police.

New Passport Photo

New Photo

The best thing about the passport incident was that I got a really good photograph for the new passport, and that is something that simply doesn’t happen to me very often. 🙂

Thinking that I wanted to anticipate all the possible trouble I might have, a) having no photo ID, b) facing the likelihood of fatigue because surgery, c) looking like a mummy in my face wrap, and d) being a tranny, I figured it would be best to take the 12:30 shuttle to the airport for my 4:00 flight back home. I reckoned that the 1:30 shuttle would simply be cutting it too close if I had trouble with any of those issues.

Upon being let out at the curb at American, I had a wave of fatigue wash over me, so I thought I’d check my bags right there on the curb. After waiting 10 minutes for a family to check in, I told the guy I had no ID, and he said I would have to go inside to talk to a supervisor. Fine with me, I thought, but a tiny doubt began crystallizing in my brain that while I had written the TSA to ask about having no ID, I really hadn’t checked with American Airlines. Remaining optimistic, I went inside, pushed the “baggage only” button on the kiosk, and talked with a supervisor, who took my bag and said there was no problem, and that I needed simply to tell the TSA about my situation. My bag, in other words, would have no problems. He printed me a new boarding pass that had a bunch of S’s on it, presumably to flag the need to screen, screen, screen, then he let me go.

So down the walkway at Logan I went, following what had to be another transsexual woman, a tallish, gray-haired matron from England, and told the TSA guy that I didn’t have my driver’s license. “No problem,” he said. “We’ll just mark you for extra screening. Please move along.”

At the metal detector, everything had gone through the conveyor belt when the man motioned me through. I was holding my boarding pass and I told him I needed extra screening because I didn’t have my ID. “What happened?” he asked, pointing to my face. “Face surgery,” I said. “You don’t have anything we could use?” he asked. “Lots,” I said, and listed the pilot’s license, my faculty library card, credit cards, among others. “We’ll just do the extra screening,” he said, and yelled for “Full Screen, section B,” or something like that. A thin and pleasant-looking woman started coming over, saying, “Female?” My guy kind of mumbled something about “Yeah, presenting female,” and I looked at her and said, “Yes.” So she moved me off to the side and did her inspection of my body while the guys across the Plexiglas swabbed down my shoes and other belongings for traces of bomb-making dust (or fertilizer, which made me glad I was coming from Boston and not Bedford Falls, where it’s pretty easy to run across agricultural fertilizer). As each item cleared, the pimply-faced guy would say “Shoes are OK, ma’am” or “You can take your purse, ma’am.” It smoothed over the “presenting as female” remark from a bit earlier.

But honestly, when you’ve had surgery and have just dodged the feds and are about to make it to the concourse to your freedom, being a tranny is really the least of your worries, and I took my “all is OK” sign happily and walked down to the restaurants with a spring in my step and a throb in my head. And it was only 1:30, to which the angel on one shoulder reminded me that if all had gone wrong, this could have taken much longer, while the devil on my other shoulder was whispering that I should have rested at the hotel or taken a soothing bath instead of being stuck inside the secure area with 2.5 hours until departure.

Time was killed by checking email on the phone, dozing, picking at remaining crusts in my various scar lines, and trying to adjust my bandages so they didn’t feel so mummy-like. I finally hit the bathroom and re-wrapped my head, which made me feel a lot more put-together, and then ate a terrific bowl of marinara soup.

Once aloft, I dozed some more, wrapped from head to toe in the airplane blankets because either this was an especially cold flight or I’ve become much more temperature sensitive. Upon waking, I realized that my head wraps were incredibly disheveled, so I again went to the john to fix myself and put on a little lipstick. I had to wait at the back for the drink service to clear out before I could get back to my seat, and when Ann, the older of the two flight attendants, finally got to me with the empty soda cans and I was just about to go past, she leaned up with a very warm smile and asked “Are you OK, honey? Did you have surgery?” Yes, I said, face surgery, and I was OK. “When did you have this facelift done, if you don’t mind my asking?” “A week ago yesterday,” I said. She smiled from ear to ear and said, “Well you look amazing for only 1 week — I think you’re going to look great, don’t you think?” “Yes,” I said, “I certainly hope so.” “How much did this facelift cost?” Honestly not remembering, I said, “I think it was around $20, $25,000.” “Where are you from?” “Bedford Falls.” “And why’d you go to Boston — is your surgeon in Boston simply better than back home?” “Well, I had a lot of work done, not just fleshy work, and this surgeon is really tops in doing both bones and skin.” She was very interested, standing nice and close, maybe regarding me as a tranny, but more like someone who had done something she wanted to do, as she told me later. “What all did you have done?” I figured if push came to shove, I’d explain that I used to be a man, but there was no reason at this point: “I smoothed out my forehead, had upper and lower eyelids, smoothed out the nose, did a lip lift, and smoothed out a very square jaw and chin.” She nodded sympathetically, incredulously, “And this was just one week ago?” Yes, I told her. “It already looks fabulous, and I bet in another week it’ll be beautiful,” she said warmly. “Now you don’t forget to drink lots of water, OK?”

I thanked her and worked my way back to my chair, feeling a little guilty because I think she wanted to talk more, but I was feeling like it was time to get back to my space. Just as I sat down and pulled out my laptop, here came the other attendant, smiling in a way that you never see them smile these days. Bending over my seat, she leaned over and said with secret enthusiasm, “Ann told me all about your face lift, and I just wanted to tell you I think it looks fabulous, really fabulous.” Again, not really the right place to sit down for a chat, so I said thank you and she left, presumably to talk with Ann about face lifts.

I’m sure that this episode has a lot less to do with me looking fabulous (after all, since they didn’t know me before, how do they know it’s a fabulous facelift?) and more to do with some perceived bond of sisters who, wanting to be modest but also being vain, are drawn to examples of fellow sisters who have taken the plunge in cosmetic surgery. I don’t have any other examples of this sort of thing, but I found it pleasantly affirming if a little surprising.

The rest of the trip was uneventful and it was glorious to finally be home among the bills and lawn-needing-mowing and children and fireworks and all the mundane beauty that blesses me.

Below is a series of small blog posts about facial feminization surgery (FFS) in Boston. You can skip them if you don’t like thinking about messing with faces or if you find diary-like entries annoying. I will try to return to less chatty, more reflective entries in the days after surgery.

Mary Jo and Joyce fly to Boston for FFS (6/21)

Flying to Boston was uneventful. I expected to be hounded by the Bedford Falls, small-town TSA officials for being a “traveling tranny,” or more precisely, someone whose photo ID didn’t match the way she looked. They studied my ID, the name printed on my ticket, and my face, then made some little initials on my ticket and passed me through, no body cavity search or deep interrogation necessary. I didn’t even have any special treatment in the metal detector, but Mary Jo was given an extremely thorough examination because she carried her cell phone through the metal detector in her pocket.

The only remotely interesting that happened was that in the waiting area, one fellow seemed to be staring at me, and looking away when I met his gaze. He was a college student, an athletic man in his early 20’s wearing a baseball cap and reading Sports Illustrated. “OK,” I said to myself, “so he reads you as tranny and doesn’t like it — big deal.” Turns out than when we’ve boarded, jock-boy works his way down the plane’s aisle and tells me he’s in the seat next to me. He squeezes in, looks out the window, and never looks back at me. Nothing bad happened, and for all I know, he didn’t give me a second thought. But I realized just how self conscious I still am, and remembered why I thought (and still think) FFS is a generally good idea — because not everyone I encounter will be college students and professors and because even if no one knows or cares about my transsexual nature, I’m the one who still feels self-conscious, and lowering my self-consciousness is going to be a very good thing over the long haul.

Switching planes in Dallas wasn’t hard, nor was the flight to Boston. We took the courtesy shuttle to our hotel and when we talked to the desk to check in, the man told me, “You two ladies are obviously going to want separate beds, but I’ve made a mistake and only have a king. What if you take that room for the same rate, and one of you can sleep on the pull out.” I guess I should have said something like “what are you talking about? We’re married.” But I didn’t even get his drift (i.e. women traveling together are clearly buddies and want separate beds) at the moment and thought the kingsized bed would be just fine, so we took it, getting the “Executive Suite,” two rooms, one of which has nothing but a conference table and a bar in it.

Violet Eggplant takes us around the city (6/22)

The next day, we met up with my Second Life friend, Violet Eggplant, and walked the length of Newberry Street, which has every posh shop and gallery you can imagine. We looked at Picasso lithographs (Mary Jo is particularly in love with one called Le Viol V — or The Rape 5), bought decadent Swiss chocolates, and got our senses blown away in a soap and bath-salts store called Lush, perhaps the most amazing establishment I have experienced in a long time. Laid out like a deli, this shop’s goods are displayed food-style so that your soaps look like rounds of cheeses, your facial masks are scooped out from salad bar containers, and bath salts are made to look like marble-breads. My olfactory system was in overdrive as we sampled and bought a range of goodies and were treated to some very nice hand salts, lotions, and creams by the proprietor. I didn’t see the bill, but I believe Mary Jo paid hundreds of dollars for our large bag of goodies, some of which we used in the bath and on our skin that very night, much to our delight.

After Newberry Street, we walked through the Park and into the North End of Boston, which contains the Old North Church (One if by land and two if by sea from “The Midnight Ride of Paul Revere“), old cemeteries, and perhaps hundreds of nice Italian restaurants. I had mushroom risotto, but no wine, as my pre-surgery rules forbid alcohol, aspirin, ibuprofen, and hormones, a prohibition that really pained me as this meal cried out for a big-bodied red wine. After dinner, we walked around a bit, bought pastries from Mike’s (which is enormously popular), and sat in a square talking and eating our newly purchased pastries. We parted ways and made vague plans to get together post surgery, which is frustrating for me — I’m having such a great time that it’s easy to forget that I’m not on vacation for more than a few hours more.

Boston Medical Center (6/23)

The next day, we took the hotel shuttle up to BMC, where we met my anesthesiologist, a very kind African man named Jean-Marie. He asked a very detailed set of questions about surgeries, medicine, and illnesses, and after an hour, he said he would see me the next day at 6:00 a.m. We next went to visit Dr. Spiegel (elsewhere in this blog known as Dr. East) and his capable and nurturing assistant, Kelly. We went over procedures, talked about the timeline, looked at a picture of my mother, had “before” photographs taken (with and without wig), debated whether this surgery forever prevents one from looking neutral or butch (he doesn’t believe it does), and learned that the surgery was pushed back to 9:00, so we get to sleep in a little bit.

Kelly said that 85-90% of their patients want to go home from the hospital by 4:00 the next day (still protesting that there’s no way to leave the hospital as late as 1:00 or 2:00), but there was no particular check-out time and that if I felt I had to stay, then it wouldn’t be a problem. But assuming I’m like those 85-90%, Mary Jo will pick me up and take me to the hotel on Wednesday afternoon, where the first day will be very cloudy, and the next two days will be fairly miserable, improving considerably by Friday, which is convenient, as that’s when Mary Jo returns to Bedford Falls to look after the kids and horses.

We got prescriptions for pain medication and antibiotics and good instructions on after-surgery care, and then left. Mary Jo can write about her impressions of Dr. Spiegel, but I myself was reminded of why I like him — he’s funny, intellectual, academic, and incredibly capable. Although I’m a bit nervous, he makes me feel quite confident that I won’t die on the operating table and I won’t look like a monster when I heal.

After we filled the prescriptions and bought a bunch of soft food, flexible straws, and ointments at the nearby Target, we had a small lunch and took an afternoon nap. We took a cab at 5:00 to meet our friends Nick and Barbara at a seafood joint called The Barking Crab, where Mary Jo ate just her second lobster in her life, pounding its shell with the rock provided for that purpose and reveling in the visceral experience, thankful that the restaurant provides bibs. Again, a nice alcoholic drink would have really completed my sesame-crusted tuna steak dinner, but I treated myself to flour-less chocolate cake to compensate. I figure that if I’m going to be sucking my food through a straw for a week and depriving myself of wines and scotches for two weeks prior to surgery, I deserve a rich and just dessert.

Reflections on the eve of surgery

I know why I think this surgery is a good thing for me, but I feel increasingly that I’m being selfish, vain, egotistical, and harmful to others. In other words, I feel good about my own psychology, my own identity, and my own self and its evolution that has taken me to this spot, and I also feel confident about the future that continues on this same general trajectory. However, I feel guilty for the anxiety, anger, confusion, resentment, or other negative emotions that are generated in others because of my changes. I wish my project did not require others to face issues of sex and gender and beliefs that they’d rather not face. Some of my family and friends are seeing my changes as positive and I’m overjoyed about those relationships, but I can also see the pain and sadness in Mary Jo’s face and in Slade’s email words and in Aunt DeeAnne’s averted gaze. I’m sorry for that pain and sadness, and hope it goes away, or at least fades just as surely as my GID fades away. Seen separately, the suite of procedures involved in FFS feel vain and perhaps unnecessary, but seen as part of this remarkable 2+ year journey, I think it’s a small but important segment of that trip — it’s the kind of journey where I don’t necessarily relish the twists and turns involved in getting there, but can’t wait to arrive at the destination.

I have been in my hometown for a couple of days with my two boys, as there was work to be done and Mary Jo is doing horse events this weekend. This is the first time I’ve visited since everyone learned that I’m transsexual and since becoming Joyce full-time. In the days leading up to this trip, I felt somewhat anxious, but not terribly so.

Joyce arrives in her hometown for the very first time
The drives from Bedford Falls takes about 3 hours, and I was in a desperate need for a bathroom when I arrived at my office in Empire Falls. The boys ran into the office to play as soon as I got the door unlocked, and just as I was dropping off my stuff to head to the toilet, my banker stopped me in the hall and said it was good to see me — Debra Burns is a veteran banker and I have always liked her, and I was quite happy to see she had gone out of her way to stop and chat, making very solid eye contact and a broad smile that spoke volumes. Welcome home, indeed.

Uncle Jack and sister Liz arrive to discuss family business
As Debra left to go over to her office, my sister and uncle showed up — I shook hands, made eye contact and smiled, then said that I absolutely had to dash out. I was worried that Uncle Jack would take offense since I had learned from Liz that he had worried about meeting Joyce for the first time, but when you have to pee, you simply have to pee. Turns out there was nothing to worry about, as the 2-hour discussion was easy and fruitful, and I never felt any sense of tension around “the Joyce issue.” I suspect that having business to transact really makes a difference — you can’t get too freaked out by transgender people if you want to work a deal, can you? The downside of conducting business is that we never set aside any time for talking about “the Joyce issue.” For now, however, I am happy and satisfied.

We are joined by Aunt DeeAnne at the Abstract office
We had to be at Empire Falls Title Company at 2:00, so we ceased our business discussion at 1:45 and split up to rendezvous at the title company on time. When the boys and I walked in, Jack and DeeAnne Law were already there, as was Liz, so we entered and said hello. DeeAnne may have been thinking about the house deal intensely and thus had no energy for me, but I suspect she was worried about meeting me and was having trouble making eye contact or conversing. It’s all right, of course, as no one’s head exploded and we were able to sign all our documents without a hitch.

Liz treated me and Lane and Ezra to a steak dinner to celebrate this milestone of settling the very last asset in our mother’s estate, then we parted ways and bought supplies for our ranch house at the grocery store. Didn’t run into anyone I knew.

We visit Liz and Gerald at their ranch
Later in the evening, we drove over to Liz’s house to see her grandson Rye and to say hi to her husband Gerald. He didn’t bat an eye and we joked about “you look different.” “hmmmm, is it losing 10 pounds?” “no, I think it’s something different.” And so on — it was a very nice, comfortable visit to end a very long day.

The boys and I go for a misty walk
This morning, the boys and I got up early, ate bacon, eggs, and biscuits, and then went for a nice long walk down to the creek. There were low, scudding clouds that created mist that hung on the bluffs and all the prairie birds were chirping. We saw a deer and picked wildflowers. We talked about Joyce, about coming back later in the summer, about how beautiful the plains can be, about how concepts of beauty and nature seem to depend on where you’re brought up, and about whether we would see any rattle snakes (we didn’t). It was a wonderful time together.

We visit Liz before lunch
The boys wanted to play with little Rye, their cousin, so we went back over to Liz’s place after our walk. While they were playing, Liz brought out all this unused LancĂ´me makeup, some beautiful handbags, and some unused jewelry, handing it to me and asking me what I thought about it. Not only was Liz’s sense of what would look good on me excellent, but the whole interaction felt so warm and so easy that I was nearly overwhelmed. I don’t recall ever having that sort of connection with Liz, and I found it wonderful. She gave me a necklace and matching bracelet that really completed my black-and-white striped shirt and black shorts, and she also gave me a sparkling black handbag that looks fabulous. I know it’s frou-frou and I know I’m attaching perhaps more significance to these things than necessary, but it’s a first for me and I felt like I belonged and that Liz was simply accepting her sister Joyce without dwelling on brother George at all. I’m making up for lost time and all I know is that I like this kind of interaction with my sister. I don’t know if it’s something she had to brace herself for, but our interaction seemed awfully genuine, and I’m grateful to have family like her.

Lunch and shopping in town
A trip to the bookstore, video game store, and restaurant proved uneventful.

Final visit to Gerald’s, Liz’s, and Rye’s place
After a mighty hailstorm passed overhead and Lane and Ezra tempted the fates by running out into the falling hail, we went over to the Rhapsody household one last time. The boys played with Rye and I watched the last few holes of the US open (third round) with Gerald. Liz and I talked some more, inspected her kitchen remodeling project, and generally bonded. A cool breeze was blowing from the south and as we sat outside we could see distant lighting in the thunderheads off to the east in the deepening dusk. I don’t believe I have ever felt closer to my sister, and I don’t know whether it’s because I’m finally being honest with myself, because the gender dynamic is different, or simply because we have learned to share more as we have aged. Whatever the reason, this was one of the best parts of the visit, which ended with long hugs all around.

We drive back to Bedford Falls tomorrow, but we’ll be back in late July, when I propose to hold a small party for friends of mine who are attending the Bedford Falls High School 30th reunion. I have decided not to go to the official reunion events so as not to make waves, but if any of my old friends want to see me, I’ll have barbecue and beer at my place as an alternative or a precursor to the official reunion activities. After my welcome these past two days, I’m feeling more and more at ease about the prospects of reestablishing my connections in my hometown.

In brainstorming what I should do in Boston, my friend Julie Slade suggested I visit the MAC store in Boston for a private consultation on makeup. Not having any makeup of any quality myself, and not having ever had an expert match foundation to my skin, I thought this was a smashing idea. MAC logo

When I arrived in Boston on Wednesday evening, I studied the MAC website and discovered there was a counter at a Macy’s just a mile away at the North Shore Mall. However, I remembered Julie’s recommendation and chose to take a cab into Boston the next day so I could visit the dedicated MAC store. The website said you need an appointment for this private consultation, and I was kicking myself for not doing this research and making this decision earlier. What if tomorrow came and I called and there were no slots? I vowed to call as soon as they opened the next morning.

Thursday, I got up, called the MAC store at 9:00 and learned they weren’t open until 10. OK, thought I. I’d like to be back to hear Mara Keisling in the mid afternoon, so I need a plan. I couldn’t tell whether the consultation was limited to consulting or if it involved a full make-over, so I hedged my bets. I got dressed, black jeans and boots and a Coldwater Creek red sweater and matching scarf, and figured, ok, if I get a makeover, I’ll need a wig; if not, then I’ll just continue looking like this, so I took my smaller wig and waited for 10.

At the right time, I called and asked for a personal consultation, to which Jason said there was room in the afternoon. “What about high noon,” I asked. “That’ll do, too,” he said.

So I took my bag (with wig inside), bundled up for what I expected to be a chilly day, and hit the road. Cab got me there in plenty of time, so I walked around, got coffee, visited the Borders bookstore and bought Jenny Boylan’s new book I’m Looking Through You in case we ran into each other at the conference and I could ask her to sign my book. Walked quickly to MAC and realized that Mary’s down coat was industrial strength, and I was boiling. Zipper down, shirt open, hat off — still steam was rising off of me like the New York City subway vents.

Jason, a smallish gay man, met me at the door: “Joyce, come right back here to the little private studio.” He kindly loaned me some tissues with which to wipe up all the sweat from getting overheated as we talked about what I wanted. Nothing glam, I told him — this is professional, not drag. He said they do lots of transsexuals and we’d go slow and talk about color and technique this morning and he wouldn’t push anything I didn’t want.


We tried a lot of different foundation, but came up with a great color match that’s suitable for both heavier and lighter coverage, and that ought to serve me well as I get rid of the rest of my beard hairs. Jason employed nothing but brushes — no pads or cotton balls for him, and he was quite boastful about the fact that MAC employs artists. So I felt a bit like a canvass in a studio for a little while. And technique was discussed at every turn, and I took lots of mental notes. For the eyes, Jason put a bit of eyeliner all the way around the eye, rather than just under and outside, and we talked about the effect of the really thin line on the inside. Having never lined all the way around, I found the look nothing like I had imagined. And “lined” is not what MAC does — it’s more like smudge right down into the roots of the lash hair, which has a really nice look (certainly a lot more interesting than a big thick line of liquid riding a millimeter above the lash line!)

Jason and I talked about colors quite a bit and went with muted earth tones and autumn/spring colors instead of anything bright. And I guess a good sign was that because of this approach, I never felt I was getting “made up.”

I told Jason of Mary Jo’s prohibition against blue eyeshadow, and he said that my blue eyes would really do well with a sophisticated blue, and that while Mary Jo is right to be horrified by trailer-trash bright blue eyeshadow, there are some fabulous shades that would look great. While I was persuaded, I was not swayed, and we stuck with browns and that sort of thing.

My question about consultation vs. full makeover was answered very quickly; once we had decided on a foundation or a color, Jason’s artistry swung into full-gear and every nook and cranny got the artist’s touch.

Picked the foundation and a matching powder, eyeliner and mascara, one very neat eyebrow pencil that’s a cross between pencil and pen, one blush, two lipsticks and one lip-liner (nice and subtle, hardly noticeable), a little compact of 4 eyeshadows (one dark, one light, and two mediums), along with a couple of brushes.

Jason sighed and said, “I wish you had your hair and didn’t have to wear this big Russian furry hat,” to which I replied that I had indeed planned for this, and produced the small wig, which Jason styled and left me looking actually quite decent — not my old self, but not so entirely different that it wasn’t me. Which was the goal, no?

I paid, Jason entered all my choices into the big MAC database for future reference (and future earnings, as it seemed awfully easy to blow a lot of cash at their establishment), and I walked out into Boston as the new professional Joyce for the first time. I had anticipated that it would be a big deal, with the themesong from the Mary Tyler Moore show swelling in my head (“You’re gonna make it after all”), and with a glow from the new Joyce evident for all passers-by to see. Actually, it was a lot like being me, just different — walking around, getting a coffee, seeing the city, and eventually grabbing a cab pack to Peabody were simply mundane undertakings.

But when one has been buried for month upon month with angst about gender and identity and the future, the mundane is so nice, so boring, so normal.

If you’re the kind of person who likes details:

Powder Blush (margin)
Studio Fix Powder plus Foundation (nw25)
Full Coverage Foundation (nw25)
Eyebrows (lingering)
Eye pencil (stubborn brown)
Lip Pencil (spice)
Frost Lipstick (sequin)
Lustre Lipstick (viva glam vi)
Eye shadow (twinks-dark, satin taupe-medium, mythology-medium, blanctype-light)
Plush Lash mascara (plushblack)

Somehow in my consciousness over the winter and spring, I developed a plan (if you can call it that) to begin doing something about my hair, or more precisely, my lack of a full head of hair on top. As a man, I had always just borne the burden, as it was typical of my sex. But as I began to contemplate an alternate reality (still awfully imaginary at the time), I realized I might need to do something. I wrote to Bosley on their website, and soon I was deluged with print packets, DVD’s, emails, and helpful phone calls, all following up on the sales lead. I studied the materials and weighed the pros and cons. The pros were these: I would benefit from the hair whether I decided to transition or not, the procedure was financeable at 0% through Capital One Healthcare, and the timing was such that I could do it and pretty much be through the ugly part of it in the slow time right after the spring semester ended. The cons were these: I would be giving in to pride and buying in to the cult of transparent beauty (something I had resisted in so many ways over the years), I might simply be wasting my time and money because I have so much hair loss that I would be chasing a dream of a full head of female hair.

So I took the middle path and did nothing, opting instead to dig deeper through an initial consultation at a Bosley clinic. I flew to Dallas on June 19th and got a ride over to the clinic, which is only 5 minutes from Love Field and very, very convenient. I was quite nervous and ambivalent about being there. On the one hand, the visit was necessary to either prove the folly of a hair transplant or to convince me that it was something I wanted to do. On the other hand, the visit would necessitate disclosure of my medications to the doctor, and I really wasn’t ready to reveal this secret to just anyone (only my doctor and my wife knew at the time).

Since almost everyone who goes to this clinic is a man in his 30’s or 40’s, everything about the clinic was designed to make such a person feel right at home. Televisions all around the waiting rooms, consultation rooms, and surgical rooms played ESPN highlights, CNN news, or Wall Street tickers. The front waiting room’s coffee table had sports magazines, sports sections from the Dallas Morning News, men’s health magazines, and GQ-like men’s life/leisure magazines. Suffice to say it’s not necessarily the environment that makes me feel right at home.

I was called in to talk with Alfonso, a hispanic “consultant” who I understood to be a salesman, a gentleman whose job it was to provide me with information, but also to close the deal. He drew on a giant piece of paper that had various views of a head on it to illustrate what the doctor might do when he arrived in a little bit. He showed me pictures from the brochures I had been sent, as if I had not seen them before. He talked about how easy the procedure is and how easy it was to set up a schedule. Finally, he talked about finance options.

One of the things he focused on during the finance discussion was the scope of the transplant. If you get 600 hairs transplanted, the cost per hair is $9.50. If you get 1200 hairs, the cost per hair drops to $8, and if you get 2200 or more hairs, the price flattens out at $5.50 per hair. In other words, while offering various clients various options, the pricing structure is designed as a flat fee around 2000 hairs. “After the doctor gives you his opinion,” he said, “I’ll be back to discuss what you’d like to do.”

I filled out a medical history, fully disclosing my use of estradiol and spironolactone, and waited for the doctor to arrive.

Dr. Bruce Hubert (who has since moved to the Bosley clinic in Phoenix), came in, studied my chart and the big paper that the consultant had drawn on. We chatted in a cordial but cold way for a few minutes. He came to the part in the medical questionnaire that said I was taking estrogen and anti-androgens and asked why I was taking these things. I said, steeling myself for rejection, that I had gender identity disorder and that I was investigating the possibility of fixing my baldness for the possible transition from male to female. All things being equal, I said, I’d like to have more hair. He said he understood, but said bluntly that I would never have a full head of female hair and that I would continue to lose hair and that there wouldn’t be enough donor hair to achieve what I was talking about. If I wanted to look fully female, he continued, I probably shouldn’t get the hair transplant, save my money, and wear a wig; however, if I wasn’t going to transition, then I’d be able to achieve certain things like the front filled in and some of the middle around the back. I was nodding rationally at this diagnosis while inwardly sinking lower and lower, feeling foolish for coming to the clinic, for having dreams of looking pretty, for even giving in to my transgender feelings.

I explained that I really didn’t know what my future held regarding transition and that I would have to balance all possible futures with the hair procedure. I asked, “what about T-blockers? Wouldn’t they prevent further hair loss if my testosterone levels fall to female levels?” He looked at me dismissively and said “Women’s testosterone levels are something like 15 and yours is probably 400-600. Spironolactone isn’t going to do anything about your male pattern baldness.” That wasn’t exactly the most informed answer, but I assumed that he was not informed about GID and the possibility of a patient having reduced (or eliminated) testosterone via drugs or orchies.

In any case, we plowed ahead with the medical portion of the consultation, which picked up pace because it was a more normal script. He examined my head, drew on a new piece of paper, and announced after about 60 seconds that I was a Hairloss Class 6, and that I was a candidate for hair transplant if I didn’t expect too much. He estimated that I had around 5000-6000 hairs to donate and that we could use around 2000 of them this summer to create a new hairline and fill in the thinning spots behind it, and if i wanted thicker hair, we’d have a few more hairs for round 2 in a year or so.

The doctor left and the salesman came back in and talked concretely about timing and cost, and I said I’d opt for 2000 hairs if I did the procedure, but I’d have to think it over. That was ok with him, so I returned home to mull it over.

I was a bit depressed by the whole experience for a week or so, but the more I thought about the costs versus the benefits, and as a window of opportunity was closing (i.e. getting it done and healed by the start of the fall semester), I rationalized it thusly. It’s relatively inexpensive, given my situation, and if I get any benefit whatsoever, then I’ll benefit as a man or a woman. If it’s not feminine, then I’m still going to be wearing a wig, which is precisely what I’d have to do if I did nothing. But if there was any chance of minimizing the baldness and perhaps making passing more of a reality, then why not do the procedure? If I skip the procedure and wait a year, then I’ll be one year behind. So I took the plunge and did it, just before our family vacation.

Flew down to Love Field Sunday night, stayed across the street at the Hilton. Checked out and walked around the corner to the Bosley office at 7:30 Monday morning, July 23rd, and we dove right in. The first stop was the paperwork waiting room, in which I signed a lot of waivers, studied the financing sheets again, and stowed my suitcase and other belongings. Then it was off to the procedure room, where I would remain all day long (when they say it will take all day, they mean it).

The room is hospital-room sized with something like a barber chair right in the middle, facing away from the doorway and towards a television mounted up near the ceiling. A window was on one wall, but the other three walls had work counters with under-cabinet lighting and probably 6-8 microscopes distributed around the room.

The first thing that happened was a great deal of combing and tying back the hair on the back of my head, or the “donor area.” Then they shaved very carefully around the edges, presumably establishing a very clean and clear area for working. They had told me that it would be better if I had some length in my hair, and since I was growing my hair, anyway, it was no big deal. After the graft was taken out, the rest of the hair would just fall over it and no one would be the wiser. When the preparation was all done, Dr. Hubert showed up, took some pictures, drew some lines on my head, and then left to let the technicians do their work.

First a woman (they’re all women except for the doctor) went to work numbing on the back of my head, where she used something like a tattoo gun to give me lots of numbing drugs really fast (really painfully, I might add). By the time I could react to the sound of the buzzing and the forceful way she and her assistant were manipulating my skull, the medicine was working. After I was comfortably numb, the doctor came in and began injecting cold water under the skin, which (I assume) was to separate the skin from the underlying tissue. It sounded really odd, crunchy, the sound transmitted both through the air and through my skull to my inner ear. Visualizing the procedure was very odd and I came close to getting the willies a couple of times, as I imagined my skin being inflated to rise above my skull and the crunching sound being the tearing of whatever holds the skin to the bone.

Once this whole strip, which runs from ear to ear in a ribbon-like strip, was injected with water, next came the scalpel, and a couple of women physically moved my head back and forth as the doctor cut the top of the ribbon, cut, cut, cut, turn head, cut, cut, cut. Then the bottom of this 3/8″ ribbon, reversing the technique. I didn’t feel when he cut the ends of the ribbon, but with little fanfare, the doctor grasped the skin and simply pulled the skin right off the scalp. I had visions of American Indians scalping their victims. With the strip removed like a trophy, the girls took it over to the tables where, vulture-like, 6-8 workers (all women) began to tear it apart in 1/2″ segments to take back to their microscopes, where they would harvest the hair follicles one by one. I had no idea how labor intensive this procedure would be, and I found myself absolutely fascinated by the workflow and the labor costs that must go into this business.

In the midst of my managerial musings, Dr. Hubert grabbed some mighty suture thread and sewed up my ribbon-gap with some forceful tugs, first at two or three major intersections, and then, football-like, across the entire area, and then we were finished. Whew, I thought, pretending that we were all finished. The women told me I had a couple of hours while they harvested the follicles, so I read. They asked me multiple times if I wouldn’t prefer to watch television, to which I replied that I’d really rather read my book, which was some sort of academic theory book, if I remember correctly. It helped transport me away from the room and into the realm of the body-less intellect, where I really preferred to be a that moment.

The technicians took small pieces of my scalp and, under microscopes, counted and separated all these hairs and put them in saline. After a couple of hours, when they were finished, they added up their tallies and said they had 2305 hairs. Since I had paid for 2000 transplants, I got 305 freebies, and they made a point of telling me this. I suspect it’s all a rehearsed part of the experience, allowing the patient to feel like he’s gotten a bit of a break right in the middle of a Frankenstein procedure.

The next step was quite odd (as if the rest of the day was normal. First came the tattoo gun again, all over the top of my head this time, and another run across the back of my head in case it started waking up. It hurts to get shot that many times, let me tell you. When I was good and numb, Dr. Hubert showed up again and said he was going to make the site. First thing he did was to repeat the crunchy, squishy, cold water treatment and I pictured my head blowing up like a balloon as I listened to the otherworldly crunching, both through the air and through my skull. Then came the site preparation, which sounds very pristine and precise, but what it was was 2305 jabs with what felt like a carpet needle or an awl, each one transmitting a distinctive poking sound through the leather of my scalp. One woman held my head and moved it around according to the orientation the doctor desired while another woman standing directly behind the manipulator counted every single jab. It was fast and it sounded the way my kids count to 100 when they want the treat at the end of the counting, taking perhaps 30 seconds to count to 100. Every so often, the doctor would pause and check out his work, then continue poking me, with her counting and yet another woman off to my right keeping track of the hundreds and thousands. Finally, after fighting back the impending feeling of getting the willies again, it was 2301, 2302, 2303, 2304, and a final jab, 2305. “There we go,” he said, and left me in the hands of two women technicians, who promptly began planting the cleaned and separated hairs, one in each hole. They told me this stage would take 4 hours and they tilted my head back so that my brand new scar in back was right up against the headrest. They also draped their arms around my head and face so reading was impossible; therefore, I gave in to the television and found an old Star Trek marathon and watched Captain Kirk in action. This grafting stage took an extraordinarily long time and it was pretty uncomfortable. We stopped for a Caesar Salad at about 1000, and I savored every little bite of lettuce and crouton, half hoping that the meal would never end. When I thought I couldn’t take it any more, I asked how far we were, and they said around half way, at which point I said I had to go to the bathroom. They wrapped my head with something sterile and said that one of them would have to accompany me. A little light-headed, I walked down the hall (no one around, so it was kind of eerie, and I pictured every closed door holding another patient like me) to the bathroom. I noticed that there were no mirrors anywhere, not in the halls and not even in the bathroom. I assume this was a precaution to prevent patients from barfing at the sight of their heads. Another episode of Star Trek and I asked where we were again, and they said only 500 more to go. Finally, it was over, a basketball head, numb and in pain.

A new woman I called the exit nurse gave me instructions, a care package, and medicine. She asked if I had brought a hat, and I said no, so she gave me one of those really large farmer’s caps that could hold a billboard on the front and she said to wear it loose, putting the front band on first, then pulling the back down into place. The hat felt like it sat 18 inches above my head, but I was so dazed I really didn’t care. Then she sent me on my way. Considering how busy the whole day had been, this exit was perfunctory and fairly jolting. I called for a cab and went to the airport, where I had a weather delay of 4 hours. I tried to relax in an airport chair, but the numbness was wearing off and I was in considerable pain. Finally got home just before 10:00.

Epilogue: we went on our family vacation right after this procedure, which was a little uncomfortable, but manageable. I wore a straw hat the whole time, and the 2305 little scabs began forming, then falling off. According to Bosley, all this transplanted hair will fall out because of the shock, and then ought to begin growing in a few months. We will reevaluate the experience around December.