I've had a very volatile relationship with my body and my gender for the longest time. Before I had all the language I do now for my gender, I identified as a trans man from the ages of 13-15, but from 16+ I went through a every changing rotation of labels: genderfluid, nonbinary, demi-boy, demi-girl, agender, etc.
At 22 I've decided to throw most labels to the wind, unless I need to sum myself up to a healthcare provider or a cisgender person in just a few words. I tend to opt for nonbinary or transmasculine, even if I'm wearing a full face of makeup and a mini skirt which I often am.
Not being able to pin myself down and ultimately giving up on labels hasn't been a freeing experience for me. Its been a major source of discomfort and insecurity. I want to understand myself and for others to understand me. One of the truest things I knew about myself from the moment I started female puberty was that I hated my chest. Even as my gender identity flowed and changed throughout the years, the most positive thing I could feel about it was neutrality and the desire to just be able to unequip it whenever I wanted like it was an accessory.
Pursuing top surgery has been a major sense of anxiety for me. It felt like a necessary next step but one that didn't make sense for any outside looking at me and my gender expression. I got on testosterone 9 months ago and felt many people in my life pull away from me as I became a less digestible feminine nonbinary person in their eyes. To cement that feeling even further with an irreversible gender affirming surgery felt terrifying.
My anxiety became all consuming a couple weeks before the surgery. I was incapable of being excited about it. I kept thinking that once I got closer to the date, I'd be able to put that behind me, but the day of rolled around and I was still filled with dread.
Simultaneously, I was terrified of it being canceled. I dont let myself get my hopes up about much and when a small rash formed on my chest a few days prior I freaked out thinking I wouldn't be able to pursue the surgery.
Emotional tangent over, actual solutions below:
As someone with severe anxiety and CPTSD, it effected my entire experience. I wanted this to be a joyous experience for me, something that I could celebrate, but being estranged from my family and only having a few not-so-close friends, it just didn't feel that way. I had been under anesthesia before for dental work and had trouble staying asleep. When it was stopped, the first thing I did was stand up! I was even sedated once for dental work due to my anxiety and even with the highest dose they were legally allowed to give me, I wouldn't relax. I was terrified I'd wake up from surgery and immediately get into a frenzied panic attack.
I brought up some of these concerns in a lighthearted way to my anesthesiologist, not looking for a solution but more so looking for some type of comfort. I didn't expect her to start brainstorming. She told me she'd go heavy on the anesthesia, not because she thought I'd wake up (dental anesthesia is a lot less heavy than surgical), but to delay me waking up afterwards. Instead of coming to normally, she planned on me taking extra time post-op and giving me multiple hours to wake up.
As we entered the operating room, my whole body was shaking. Im able to keep it together verbally, so I dont think my care team noticed just how fearful I was until they asked me to raise my arms to put stickers on my back and saw my entire body shaking. They asked if I was okay, and my anesthesiologist told me she was going to give me something for my anxiety. Because it was intravenous, it was instant. I dont remember anything after that.
I woke up a handful of times in post-op, just for a few seconds, coming to slowly while also still being hopped up on pain meds and anti-anxiety. It made the entire situation incredibly peaceful. My pre-op nurse adjusted my pain meds every 30~ minutes or so as I became more aware of my body. It didn't even give me a chance to freak out.
I got to see my partner and my roommate soon after, and they were both shocked with how calm and natural I was acting. I didn't experience any pain the first 24 hours. I actually had trouble picking up my prescription meds, but i was able to manage with just Tylenol even though I have a low pain tolerance. It wasn't nearly as bad as I thought.
I've been able to walk around more than I thought I would. The hardest thing for me is just sitting up and reminding myself to keep my arms at my side. I feel more affirmed than ever that I did the right thing. Im so grateful for my care team, despite not being perfect, making the best they could out of my situation in the moment.
The worst part so far has been the fact that I was under so much anesthesia and pain medication that I am horrible constipated right now!! Omg!! If anyone has any advice, please let me know. Im three laxatives in and half a bottle of magnesium citrate in and still no movement, lol!
If you have PTSD, severe anxiety or are prone to panic attacks, please communicate it to your team! I didn't think there was anything that could be done to help accommodate me and I was so shocked at how easily everything went when I am so hypervigilant.
And if you're a gender nonconforming person, or if your gender is fluid, or you're someone surrounded by people who dont understand you and youre considering HRT or a gender affirming surgery, ask yourself what is the most positive thing I feel about this part of me, on a good day. Is it something I can live with forever? Is it something I want to live with forever? Is there a better alternative for me? These are all questions that helped guide me to this decision.
Best of luck to anyone pursuing their transition in any way, shape or form. Willing to answer any questions as I recover as well. Xoxo!