Trans Facial Feminisation Surgery Part 4: Running the Gauntlet of Womanhood
NSFW: This series contains graphic images and descriptions of medical procedures.
This is the fourth article in a series about the medicalisation of my gender transition.
An edition without medical images available »HERE. Links to the other articles in this series are available below. Images are by the incomparable Morgan Roberts.
Blessings that walk in the door
As my discharge papers filter through the system so too does the lingering fog of the anaesthesia. My wife bustles in the door of my hospital room and perches on the edge of the bed. Her tiny hands take mine and she smiles the smile she’s likely thought about all night. How does one acknowledge the Frankenstein ruin of a face already mottled purple and yellow like overripe fruit? How do you validate the person you love looking the worst they’ve ever looked and still show that you think they’re gorgeous.
I don’t know. Yet somehow, she does. This blessing of a woman.
There’s a complicated drug regime and a recovery plan that I have no capacity to even begin to understand. My mind feels as stitched together as my face. Yes, I was told all these details long before the surgery, but those 24 hours of unconsciousness feel like eons, and I’m grateful to let it all wash over me.
Thankfully my partner thrives in circumstances like this.
The tangle of tubes threaded into my hairline keep getting caught up in my arms, my clothes. I’d hoped they wouldn’t be coming home with me but there’s still too much fluid being pulled by the gentle vacuum of the bulbs. The easiest solution is to hook them to the clip securing the wild bushel of my hair while I dress and wait for the all-clear to leave.
When the papers do come, all I can think is “how do they let people just leave after something like this?” but they do. I’m wheeled through the hazy fog of the return journey. Without these photos I’d have no clear recollection of any of these moments save for the feeling that I wished I could’ve walked myself to the car, wished I had a spring in my step at the beginning of the next chapter.
Clearly, it was a foolish hope.
Morgan sets up his lights. Same spot as the night before to capture the face I was saying goodbye to. That grueling day of work to shoot the operation was only part of the undertaking. Now was the phase documenting my recovery. Days, weeks and months to finally land here, a year after the fact. This year began with an aching exhaustion that had me holding the wall for balance. Had me teetering on shaky knees while an old friend did what I’s tasked him with, gently moving me to my mark and had me pose. I’d insisted he capture the weary ruin of my face, the bulge of plastic tubing in my neck to draw out the mounting fluids. I’d insisted he capture all the stitches, the running lines of marching ants framing my face and the compartmentalising sutures in my neck. I made him promise he would do it, even if I protested or resisted.
No One Wakes Up Beautiful
Every piece of media that exists about this transformation is a lie. They always fudge the details for the sake of the drama.
No one wakes up from this and is beautiful.
There is no sparkle in the eye, no sudden “knowing”. You wake up and your body doesn’t feel like yours. It doesn’t move, it doesn’t think, doesn’t work as it should. When the meds wear off the head-to-toe ache of the physical ordeal hits. Even pharmaceutical relief comes at its own cost. Pain meds always give me a lingering cough and fuck up my digestion. Turns out that uncontrollably coughing and straining to shit are the last thing you want to be doing when you have hundreds of stiches in your face.
It’s just like any other cosmetic procedure that women routinely undergo. Plucking, waxing, lasering, Chemical peels, cosmetic tattooing. The foundation of the beauty industry is pain and discomfort. Why should this be different?
So often procedures like mine are treated as a magic bullet, but it’s just the same as all the other things women do to meet the societal standard. This is what they don’t show you. This is the sad, messy reality of waking up and realising you have only just begun your run through the gauntlet of womanhood. You realise it was foolish to not expect it would hurt unlike anything you’ve ever felt before.
Missives from the belly of a ship
As a writer I’m an incurable bower bird.
My phone is full of snatched lines and moments, tiny glittering hooks with which to jog my memory. Reading back through my notes I can see how much I was swimming in painkillers, steroids and antibiotics. The breadcrumbs I left are terse and pregnant with portent. They sound like gothic-drama missives written by candlelight in the belly of a lurching ship on a months-long crossing.
Day 1: “I can feel the throb of my heart in my face when I try to stand. I have no breath. The stairs are a challenge.”
Day 3“I’ve been tasked with massaging my swollen face. Fluid moves between the layers. When I press my cheek a pocket of liquid squirts up, arcing a jet through my under-eye to my temple. I’ve no idea which direction it’s supposed to drain. I keep pushing it through the spongy chambers of my flesh.”
Day 4 : “It itches. Feels like lines of ants tracing the paths of nerves under my skin. Scratching the numb surface does nothing, they’re crawling deep under the layers.”
Day 5: “I need to taper down the medication. The pain is constant, but I can’t stand the fog in my mind and the disconnect from my body. I can’t live like that, the whole point was to make them more connected. I’ll have to manage.”
Day 6 “Sensation is returning, one screaming nerve at a time. They fire into existence unexpectedly with a stab.”
Day 7: “Sleep eludes me. But I’m happy. I want them to know I’m happy.”
God, what a fucking emo wanker.
Truth is I was just whacked out of my skull of pain killers and going loopy with being cooped up inside. I was crawling the walls. I wanted to be out in the world, to stride through the night. To see the world and be seen by the world, new face, scars and all.
But that would have to wait, we are still at the beginning.
The Clown’s Handkerchief
A mere 24 hours later and the bulbs pulling fluid from my face have slowed to a trickle. It’s a simple clinic visit to remove them. The waiting room bustles with other patients. Some bandaged up, looking worse for wear like me.
Day 2: “The took out my drains. A simple snip of a securing stitch and they gently pull the length of tubing out of my neck like a clown pulling a knotted handkerchief. Thank fuck for antinausea medication.”
Accidental Ear Removal and the Dangers of Unzipping Your Face
Morgan lugs his gear up the front steps while my wife is performing the multiple-times-a-day task of cleaning my incisions. The process ends with a gentle covering off ointment. It’s a week since she wheeled me out of the hospital and it’s time for my stitches to come out.
Day 7: “More than a hundred stitches removed. The nurse, I’ve no idea what she looks like other than the blue eyes above a mask, explains that she needs to undo every second stitch to see how it holds. If she starts taking them all out the sudden release of pressure could open the incision and unzip my face.”
Day 7: “I learned that I tore my earlobe off absentmindedly. I Didn’t feel a thing. At the time I’d no idea until told there was blood on my neck, in my hair. The surgeon has reattached it. Not sure how to explain what happened.
Shave and a shower
With the running stitches out and only a handful of remaining I’m allowed to bathe. It’s only been a week, but my unreasonably bushy hair has been constant frustration. I’m still exhausted with the slightest effort. Morgan stands by, leaning on the bathroom sink snapping photos of the blood clots tangled in the comb that managed to survive the “biohazard bag shower” I had on the surgical table. I show him the mystery bruise on my ankle.
“Oh they took blood out of you and injected it back into your face!”
What. The. Fuck?
“Yeah! Spun it down in a centrifuge, and injected the plasma into your face. Helps healing.”
Day 7: “I’m allowed to wash. My beard has grown in, what’s left of it. It’s the longest it’s been in years. I’m worried about shaving. I can’t feel my face yet. What if I slice it off accidentally?
Laser treatments have all but obliterated by beard, but I started my transition at 40 and was already greying. My skin does not enjoy electrolysis, the broken capillaries are still visible two years after my attempt to finish what the laser started. Those salt and pepper sprinkles in my beard that the laser didn’t get will be with me forever, so it’s the old razor unfortunately. I went slowly and carefully through the ritual of it. Thankfully I didn’t slice my face off or anything, but something else much more remarkable happened instead.
I saw “her”.
Day 7: “For years I’ve only ever caught glimpses of her in the mirror. I’d stare and stare searching for her. Nothing. But today I looked. She stared back at me, clear as day, eyes bright.”
The Woman in the Mirror
Morgan, holds his camera away for a beat, giving me a moment. All I could manage was to mumble the words “get it”, the shorthand I’d use with him in a photoshoot if something marvellous was unfolding beneath the lights. He knew what I meant. He’d given me the grace of choosing in that moment to follow through on what we talked about, the veil of dignity and vanity, and how capturing this was exactly the brief.
And just as if we were on a shoot for a client, he didn’t let me down.
Day 7: “I’ll never be able to explain to her how grateful I am. For all my florid prose, my verbose smokescreen, I’ll never be able to express just how lost I would be without her.”
One week of recovery down. 51 more to go.
–S
The images and text published here are an individual case do not constitute a testimonial or medical advice. Any surgical or invasive procedure carries risks. Before commencing your surgical journey, please seek medical advice from an appropriately qualified health practitioner.
More in this series…
“I paid to have my face cut off and reattached”:
Facial Feminisation, Liposuction and the Hope of Change.
Published while undergoing facial feminisation surgery in 2024, this article describes liposuction and waistline crafting, my first transition surgery.
Trans Facial Feminisation Surgery Part 1: The Block of Immovable Stone
Unwrapping the aftermath, Nicholas Cage and the lies we tell ourselves.
Trans Facial Feminisation Surgery Part 2: Veil of Dignity and Vanity
Not holding back, Disney animators and winking out of existence.
Trans Facial Feminisation Surgery Part 3: Sleeping Beauty in a Medical Waste Bag
Disassembling my face and addressing the excess.
You look so beautiful in those photos! Thank you so much for sharing - the writing is great.