The Road to Gender Affirmation Surgery

Mila Madison

There are many moments throughout the process of transition that could be considered milestones. Defining events that ultimately shape your journey. Accepting the fact that you are transgender is certainly the first one. Coming out to everyone you know is certainly another. Along the way you will make decisions that will affect every aspect of your existence. Are hormones the right path for you? If so, it is certainly another milestone when you start. Whichever steps you choose to take, we are all faced with difficult decisions that not only affect us, but those who are around us.

We are all different in how we get to the moment to when we accept our true identities. Once we do get there, where we go from that point is also different for all of us. Though we all may share the common experience of falling somewhere under the transgender umbrella, our choices and experiences within it are all individual and different. Among those choices is something many of us have to consider, whether it is right for us or not to have surgeries.

The prospect of gender affirmation surgery was something that I have always thought about, but it was never a real possibility for me to consider seriously. Having a family to take care of I could never afford it and I never had the right kind of health insurance to cover it. I always had a way out of thinking about it because the thought would always end with, “Well it is not even possible anyway.” Admittedly there was also a fear of having to go through any kind of surgery in the first place, and there was a sense of safety in being able to avoid having to make the decision. Regardless, my transition had always been about my own head and being able to think straight. A big piece of that puzzle for me was hormones. I was better in so many ways just due to the fact that I had the right kind of gas (estrogen) running my body. For a little while I was content with where I was in my journey without having to consider what may be next.


As my body began to transform, the funhouse mirror I always saw my reflection in started to change. Over time I started to see myself looking back at me. I had never realized how bad my dysphoria actually was until I started to experience short moments of not feeling it. Things began to get so much better, but out of it emerged dysphoria with regards to the parts I was given at birth. I had never felt “trapped in the wrong body.” I had really only seen myself as being born with this “body part” that I shouldn’t have in some sort of anomaly in nature. At first, it was just something I had to accept about myself, but the further along I made it in my transition, the more it began to bother me.

As time progressed the thought of having surgery began to occupy my thoughts more frequently. I began to know that it was what I wanted, but I still had many fears. For one, it is a major surgery, and so much could go wrong. There was also the prospect of aftercare, dilating, and scarring. I had concerns about which surgeon I would use and how to find the right one. I thought about how it could affect my marriage and sex life. There was so much to consider. Still, there was no way I would ever be able to afford it anyway, so I sat by while all the best surgeons began to get booked for years to come and there was nothing I could do about it. Never one to give up, I began to look into ways that I could actually make it happen, somehow.


My reason for wanting surgery is not that I think it would make me more of a woman. I would feel no sense of validation at all through it. What it would do is be a major victory in my battle with dysphoria. I had always seen myself as an incomplete person in that mirror, and I can’t imagine what life would be like without having to see myself that way. No more wearing long tops out of fear of anyone looking at my lower half, or dreading summer because I was afraid of anyone seeing anything in the slightest way. Yes, these things mattered to me because in this way I was hiding myself and I was still ashamed of my body.

Finally a window of opportunity opened up for me. After leaving a job that wouldn’t cover transgender care in their health plan, I was able to get insurance that could possibly cover it. Realizing this may be my only opportunity to ever have gender affirmation surgery, I decided to move forward with it. I got my letters and made my initial appointment. This may be the beginning of a long battle with the insurance company, but for the first time in my life I feel there is hope. Besides, I’ve had to fight for each step I’ve taken in this transition and I am sure this time it will be no different.

All at once I feel elated, concerned, and terrified about this next step I am about to take. I find myself thinking about everything I went through to get this point. And though I know this wouldn’t be the end of my journey, it would certainly be a major milestone in my transition. I still wonder if everything will actually go through in the end, but it is something I am willing to do everything I can to see it through. For a long time now I have felt as though my transition has been stuck in the mud. Though the are so many unknowns ahead of me, it is good to know that I am moving again.

Comments (3)
No. 1-3

When i started my transition, surgery wasn't really on my radar. But as i got further along, i finally figured surgery was needed for me to feel complete. It can be a very difficult decision to make plus finding the right surgeon. It was the best decision i ever made and have no regrets.


Having this surgery was the best thing that I ever did. It has had a positive effect on my life in ways I hadn't even considered.


We all have our own stories til that finally day when life switches and wee see ourselves after sergery. Is a long road of choices and hardships you alone must come to and make the deccissions of what to do. Only thing people can do is help with what they can do. You have to hold your own hand and do what you have to complete this journey to the end. And even after sergery that road never ends you have to stil stay true to yourself and make ever choice and deccission what to do as you go. Transforming does not mean the end of the road and like a light on or off things go away and you can stop. Myself i am a totaly unashamed unafraid person i probably conquere obsticals not many trans people even think of. But no mater what happens i take the control i need to make the best of all problems. Hugs karrie falon post op male to female

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