Transitioning to happiness

That is a “before and progress” picture of Kieran, who is currently in the process of transitioning from female to male. Kieran told me he is “an open book” and that I could ask him whatever questions I wanted. Thank you to Kieran for answering my questions so honestly and for sharing so much information!

Caitlin: When do you first remember struggling with your gender? Can you share a bit of your back story?

Kieran: When I was in first grade, I have a distinct memory of saying things like “If I were a boy, I would like…” I absolutely was a “tomboy” and played primarily with boys toys. Around that time, my very young uncle used to tell me stories that started with “When I was a little girl…” He told me that little girls turned into boys around 11 years old and vice versa. I was beyond excited and looked forward to this like you could not imagine. At some point, I obviously realized that was not going to happened and was pretty sad.

I continued to feel like I was basically just an awkward tomboy for a number of years. Around 13 or 14, I realized that I was exclusively attracted to women. I still tried to have boyfriends, because I was not really able to come to terms with that. I still had this thing in the back of my head that I didn’t really understand. Through my teens, I would date guys that I wanted to be like, not that I actually wanted to be with, but I hadn’t yet been exposed to the transgendered community and so I sort of just chalked that up to being a lesbian. I dated a few women in my teens as well. I had a fair number of other issues when I was a teen, so it was hard to understand everything I was dealing with.

At around 18 or 19, I was exposed to what it meant to be trans. I was in college and was meeting more people and also took a LGBT history class. A giant lightbulb went off in my head and everything suddenly made sense. I talked to all of my friends at the time and began to live life as a male for a short period of time. I had been out as a lesbian and only dating women for a while. I finally felt good in my own skin when presenting as male and was happy.

I told people back home and it did not go nearly as well. I freaked out and thought that perhaps all of this was related to some other issues I was having. I reverted WAY back in the closet and started dating a guy pretty seriously when I was 19. That obviously was a disaster and didn’t last.

At 20, I started dating a woman. A year or so into dating her, I let her know about being trans. I attended trans support groups and was pretty ready to make a transition. The problem at the time was that many people that were transitioning when I was 20 were in the 35-45 year old range. People waited longer. And, it was expensive and not as available as it is now. So, I had made a decision that I would wait a few years.

Before I got to the point that I was going to transition, I got a job at Friendship Hospital for Animals. I decided that when I left Friendship, I would transition after I left that job but before starting whatever job I took next. At the time, there were not protections for being trans in the workplace and it was rare that people would transition while staying in a job.

So, I waited. And waited. And waited. And nearly 15 years went by and I was still at Friendship.

I started dating my wife, Caitie, in 2006, and she was aware before we started dating. I continued to hide it from some people at work (some knew) until February of this year. At that point, I felt like I just needed to transition whether that meant staying or leaving the job I love. I made sure all of the managers that reported directly to me knew and then I told my boss. It went well. (More on that below)

Caitlin: I understand that you are married with children. Can you talk a little bit about how your family affected your decision and this process?

Kieran: I am. (My wife Caitie and I) have 3 kids– a 4.5 old son and 2.5 year twins (a boy and a girl). The kids have called me “Baba.” Caitie picked it, it worked for me. We figured, since I had not transitioned, if they called me “Dad” out in public, it might confuse people and be difficult for my kids to understand if people made comments. And, there was no chance we were going to have them call me Mom or anything like that. So, Baba it is.

My family is the main reason that I finally pulled the trigger. I have struggled with depression and anxiety for about 20 years, much of it related to severe body dysmorphia (I refused to look in mirrors, for a while drank kind of heavily to self medicate, etc), and just a complete uneasiness with who I “was” to the outside world. However, I just resigned myself to being miserable. But, as our oldest started school, it became clear that something needed to be done. He has always referred to me as a boy. He never even asked, he just knew that there were 3 boys in our family and 2 girls.Well, kids and teachers at school didn’t necessarily see the same thing and that was confusing. I felt like I needed to fix that.

I also felt like if I wanted nothing more in life than for my kids to be happy, then I had a responsibility to be an example and be who I was supposed to be. So, I mustered up the courage and took the plunge.  

keiran 3

Caitlin: Tell me a little bit about what the process is like. Where are you in the process? How are you feeling?

Kieran: Sure. The process is slightly different for everyone who goes through it. There are standards of care set by WPATH (World Professional Association for Transgendered Health), but every provider interprets them a little differently and everyone is at a slightly different place when they make the decision to start transitioning– some people never medically transition and just live life presenting as their true gender, some people go through an entire medical/surgical transition. I can only speak for myself and my experiences.

When I decided to take the plunge, I told everyone that did not already know. After telling everyone in person that I could/needed to, I wrote an email to my entire company at work. I was afraid to send it, so the managers all stood around me and one of them hit send. They then took me out for a drink, because I was too afraid to face the team (it was fine, I was just freaked out). I posted my story on Facebook.

At that point, I had contacted a therapist who specialized in dealing with transgendered health. He met with me. Because of my age (old, haha) and the fact that I had been out, at least in some circles, for more than 15 years, he didn’t feel like I needed many sessions and he told me he would meet with me 3 times. He thought at that point he would be prepared to write a letter to endorse the need for a medical transition. If he couldn’t for some reason, we would keep meeting.

Our first meeting was typical talk therapy. He asked me questions about my life and experiences. For the second meeting, he administered the MMPI-2 (Minnesota Multiphasic Personaltiy Inventory). This test is 567 true false questions that apparently identifies a variety of mental health issues and also scores you a male/female scale. The goal was to identify if there were any reasons why I may not be able to handle making the medical transition. My score came back with slightly heightened anxiety (but not high enough to fall in the clinical diagnosis category) and a completely lopsided male/female scale tipped overwhelmingly male. He met with me once more to go over the results, ask a few follow up questions, give me local references for endocrinologists who work with transgender individuals, to let me know what to expect when I started testosterone, and to let me know to schedule an appointment with him if I had any issues come up throughout the transition that needed attention.

A few weeks later, I was able to meet with the endocrinologist. He did a physical exam, ordered some blood work, gave me a testosterone prescription and told me to come back in a few weeks when I was going to receive my first shot. He would show me and my wife how to administer it and then we would do it weekly after that. I received my first testosterone shot on March 27. I got blood work one month later and met with him on my birthday on May 1. My lab work showed that my values were all normal and I was tolerating the testosterone well. It also showed that my estrogen had been suppressed and my testosterone was in the normal male range. I complained about headaches on day 7 when the testosterone was due that would start in the morning (I did my shots at night) and last until the next morning. He suggested that I switch to every 6 days for my shots instead of every 7.

My plan had been to hold off on any surgeries until spring of 2015. However, with the start of testosterone, it became unbearable to continue to have the large chest– despite binding. I met with the surgeon in July and scheduled my top surgery for September 16. She also required a letter, so my therapist sent that to her. She also required that I get medically cleared by my primary care physician, so I did that. I also had to stop testosterone injections by getting just 1/2 dose 2 weeks before surgery and then none until a few days after.

In less than 48 hours, I will be going in for top surgery. The type of surgery I am getting is the double incision method. The doctor will make two large incisions under my breasts and perform a full subcutaneous mastectomy. She will remove, resize and then graft my nipples into the appropriate place to give my chest a male appearance. I arrive for the surgery at 8am. They give me a Xanex for anxiety and Zofran to help ease nausea. Then, they will talk to me and my wife about the procedure and post-op care (again) and prepare me for surgery. At 9am, they will take me in to surgery. She said she expects it to take about 2 hours. I will be in recovery for about an hour and then sent home with some narcotic pain medications and ambien to help me to sleep for 10 days. I will need to wear a surgical compression vest for weeks and will have surgical drains placed for about a week.

Because I was born in Pennsylvania, I need to undergo ‘sex reassignment surgery’ and have a surgeon write a letter in order to change my birth certificate and social security gender marker. So, this surgery will satisfy that requirement.

The next surgery that I would undergo would be a total hysterectomy. This will ensure that I no longer need to visit the gynecologist to screen for cancers as well as stop my body from trying to produce testosterone and we can likely reduce my dose, though I will be on it forever. I’d like to do the hysterectomy in the spring or summer of 2015.

The final surgery would be bottom surgery. There are several methods and everyone I have talked to in the industry recommends waiting a few years as technology is improving rapidly in this area. Some female to male transgendered individuals never take this step.

Caitlin: What has been the biggest surprise of transitioning?

Kieran: I have two things I would say are the biggest surprises. First, how quickly the transition happened. I expected it to take much longer, especially with having a large chest, to be passing in public 100% of the time. About a month and a half ago, 4 months in to the testosterone, it was completely shifted and everyone called me sir. When I went to Philadelphia in June, everyone was calling me sir, but DC took a little longer and until early August– my theory is that with DC being so liberal and having such a high gay population it is actually harder to pass because no one wants to offend, so they try much harder to figure out “What you are” vs in Philly or other places we have gone where people see short hair, men’s clothes and a tie and just default to sir.

Secondly, how much calmer I became within just a few weeks. My anxiety disappeared almost entirely within the first month and entirely by 3 months. My overall personality just became far more relaxed as I got more comfortable in my own skin. We had been afraid of “‘roid rage” because of the testosterone, but really the opposite happened.

Kieran 2

Caitlin: What do you think is the biggest misconception people have about transgender people?

Kieran: That’s hard to answer. I guess that we aren’t like them. My wife and I have a house in the suburbs, 3 kids, 3 dogs, 2 cats, a minivan, watch bad reality TV and have Chipotle Friday nights. We are just like everyone else.

Caitlin: I think a lot of people hesitate to ask questions because they are afraid of offending. What do you think is the most important thing for people to understand about people who identify as transgender?

Kieran: There are a lot of different people who fall on different parts of the gender spectrum, so it is hard for me to answer for everyone. I think, for me, if you don’t understand, ask the question. If you respect me, then you need to make a huge effort to use the correct pronouns. I was a depressed, anxious person before this transition and my mental well-being has improved 100-fold. This was not something I could suppress any longer.

Caitlin: What has been the hardest part?

Kieran: The hardest part has probably been being patient. Even though I said that it’s all happened so fast, it also is hard to be patient… waiting for the ability to pass, waiting for the top surgery, waiting for full facial hair, etc.

Caitlin: What is the best part?

Kieran: The best part has been the ability to finally see myself when I look in the mirror. To finally have some peace when I am out in public. To finally, after so many years, be completely happy with who I am.

To learn more about Kieran’s story you can check out his blog, here.

**Update: Kieran has generously offered to answer any questions you may have. Leave them in the comments or on the Facebook page and I’ll make sure Kieran sees them.

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