Sunday, 30 June 2013

Vlog: Back Again, Surgery And My Farewell To Intersex

Topics in this video include:
- What has happened since my last vlog video in late 2011.
- My impending surgery.
- My current views on being intersex and intersex in general.
- How I regard my future.


Friday, 28 June 2013

Fifth MRI Scan And Onwards To Surgery?

Today was finally time for the MRI scan my surgeon requested to fully prepare for the surgery. This is now my fifth MRI scan so far, and fourth abdominal scan. I can't really say anything about this other than that I'll be glad to never see the inside of an MRI scanner again. Not because it's such a horrible experience, but more because of the countless mostly negative memories attached to it for me. This became apparent today as well, even before I headed off to the hospital.

Let me first say once again how glad I am that I have such a flexible freelancer job which allows me to just fly off to appointments at any point of the week in the knowledge that I'll compensate for the hours at some other day. Thus at some point before noon I went to the train station. Even just walking there on the streets I felt kinda odd. One moment I'm sitting there, in front of a bunch of laptops just doing some work, then suddenly I'm walking here in the cold towards an appointment which I feel rather apprehensive about. Or more that it's that I have given my body the instruction to walk there because some part of me feels the need to fix something which wasn't right at birth. The burden of the body on the mind.

Today was a bloody cold day considering that it's supposed to be summer. Only about five degrees Celsius did we get today, with a strong north-western wind and the resulting urge to really wrap oneself into a lot of clothing. I was relieved that the train was only delayed by about a minute or two. During the train journey I entertained myself mostly through reading up on my Twitter and Google+ streams. I managed to do a bit of research on a project I'm working on at the moment as well. Bless the 3G gods for speedy mobile internet.

Once arrived at my destination it was only a short walk to the hospital. My first task there was to update my existing data there, considering that I hadn't been there since probably 2006. This meant having them update my address, GP and of course first name. Amusingly enough when I first registered at this hospital over seven years ago they already had registered me as 'female', ergo this section of the registration remained unchanged. I must say that I was relieved that this was the case. It's humiliating beyond belief when you are a more or less regular woman and you get addressed as 'sir'. I have written quite a few times on this before, prior to my official gender change early last year. It was bad enough to have to explain that the first letter of my first name wasn't the same as on my passport because I had my name changed. Fortunately the lady behind the counter was quite nice, making the process quite painless.

With the registration up to date, I went to the radiology department for my appointment. After the expected fuss about the old first name's letter versus the new one's, I was told to wait my turn in to the MRI section's waiting room. This I did. I got told there that there'd be about a fifteen minute delay on my appointment due to previous scans taking a tad longer. This meant that I had to wait about 45 minutes. No problem with a smartphone with fast internet. Before I knew it the time had passed and an assistant came to pick me up. After the usual routine questions about metal in/outside the body and to ensure that they had the right patient I got asked to change before the scan. Before the assistant walked away I asked her a few questions about how quickly my surgeon would get the scan images and whether I could get a copy as well.

The reply was that the images would be sent to the surgeon right away so that he'd have them early next week, while I could pick up a disc with the images and the MRI report in about a week's time after arranging this at the front desk of the department. Satisfied, I got some comfy pants without metal bits in them to wear and changed out of my jeans and removed the bra. This left me metal-free. Briefly after finishing changing the assistant came to pick me up again and led me to the MRI room, where I was greeted by another assistant. Together they prepared me for the scan. Most interesting thing I can say about this scan is that I went in feet-first, instead of head-first like with the previous three abdominal scans.

I also got earplugs in addition to the usual headphones as this MRI scanner was supposedly quite loud. After those preparations an additional antenna was put on my torso, in the form of a big metal and plastic shape with a connector which plugged into the bed I was lying on. This supposedly should offer the enhanced resolution the surgeon needed, negating the need for contrast dye. I didn't further ask for details about this. With all that arranged, in I went.

The initial part of the scan was noisy, alright. Right on the edge of what was bearable hearing-wise. The next two series were similarly painful. After that the series became less noisy, and I was able to sink back into the routine I adopted throughout all those previous MRI scans: just letting myself drift away while popping back to full attention whenever the scanner's noise ceased. I somewhat lost track of time, beyond what the assistant told me throughout the scan. Based on her time estimates I figured that I was in there for significantly longer than the twenty minutes of the previous scans. Curiously, I also began to feel a warm sensation inside my abdomen, something I hadn't experienced with the previous scans. This reminded me of what an American friend who operates MRI scanners for a living said about patients reporting such a feeling.

Finishing up the scan, I was let out and the structure around me disassembled. After another brief chat with the assistant to ensure that I could just make an appointment with the surgeon for next week, we shook hands and I went into the dressing room. After getting changed again into my own clothes I went to the department's front desk and arranged that a CD-ROM with the scan and the radiologist's report would be prepared and that I would receive a phone call about it when I could come pick it up. It disappointed me a bit that I would have to make another trip to pick it up, but it's hardly the worst thing so I agreed to it. I guess it does make sense in the regard that otherwise such sensitive medical data could end up in the wrong hands.

After all this it began to really dawn on me that this meant that yet another radiologist would be putting a report about an MRI scan of mine together. Previous MRI reports by Dutch radiologists all indicated that they couldn't see anything indicating a female physiology on the abdominal scans. I am quite curious what this radiologist will conclude. Not that it would change anything about the fact that I do indeed have the aforementioned female physiology, but rather about how far this 'conspiracy' against me stretches within the Dutch medical community that it would pit three German radiologist and physician teams against about five Dutch teams. Then again my decidedly Dutch surgeon can also see this physiology on the scan images, ergo it isn't inconceivable that this new radiologist would also agree with the German conclusions. If he does, it would definitely be a nice contribution to my legal case against the Dutch hospitals and boost my confidence in the system a bit again.

Making my way to the hospital's exit, I said goodbye to the lady at the front desk who had assisted me with the updating of my information earlier. Walking outside, I still felt quite warm. Opening my jacket fully I just barely didn't start sweating. The trip back was rather uneventful as usual, except that somewhere halfway through the train journey I began to feel weird. Somewhat sad, overburdened in an emotional sense and almost depressed. It was then that I realized how much impact this whole experience had had on me. It had pushed me to the verge of an emotional breakdown. In some ways it reminded me of previous times when I had been sitting there in the train years ago, just staring outside and feeling so incredibly miserably.

This time around I didn't feel miserable, as back then I didn't know what the heck I was. I just felt so incredibly tired. All this fighting and nobody ever telling me why I have to fight for something so minor. Why so many medical and other 'specialists' felt the need to mess with my head instead of just providing help. I guess the weight of over eight years of my life going up in smoke just like that to please the sadistic pleasures of said specialists is really pressing down on me. On days like these when I'm confronted with all the doubts, frustrations and intense pain all over again, doubly so.

Arriving at my current residence I called the clinic to make an appointment. While I could go there on Monday already according to the assistant, I figured that later in the week would be a better idea. The assistant at the hospital had said that Wednesday or later would be fine. Now I have an appointment for later next week to see the surgeon again. My hope here is that he finds the new MRI scan sufficient, and gives the go-ahead for the surgery, which would then likely take place the next week. That'd then just leave me with the burning desire to find out the surgery results. I do so hope that he can indeed find the entrance of the vagina so that it can be reattached to the labia. If that were to fail I would end up with still very little there. It would feel a bit like all this trouble was for nothing and I might as well not have bothered.

But again, it's all for the sake of this body, I guess. It's so very demanding it seems :)


Monday, 24 June 2013

Attacked By One's Own Brain; Continuous Triggers

Yesterday seemed like a pretty alright day. Second day of the weekend, with me working on projects for my company, including a fun cross-platform audio-related mobile project. By the end of the morning I began to suffer from a mild migraine, however. It felt like a painful, nagging feeling behind the eyes, worsened by exposure to light. I recognized it as the typical stress-induced migraines I tend to suffer from. Fortunately not the type which announces itself with the silver-grey aura prior to demolishing every part inside my skull, which is the type I suffered mostly from during high school. Also fortunate is that this mild type can be dealt with using paracetamol painkillers.

During the afternoon the migraine returned again and I had to take another painkiller to deal with it. I felt pretty worn out around 9 PM already as a result and went to bed early. Unexpectedly that's when I got one of those memory cascades, also known as PTSD attacks. Thoughts of the still unresolved situation regarding the apartment with my possessions in it which is off-limits due to being foolish enough to trust the wrong person, cascading into more and more memories of the time spent there, images of hypothetical situations and solutions to deal with that situation. Branching off into more and more memories of so many experiences, most of them beyond painful. So many things related to sexuality, relationships, people bullying me, physicians and psychologists ridiculing me. Just spinning around inside my head set to the tune of pure insanity.

I'm sane. I'm quite sure of that. That my consciousness tries to resist such a sudden influx of horrible recollections and scenarios is proof of that. It's a horrible experience, however. Unable to stop the torrent, one can only try to shut it out as best as possible and allow one's emotions controlled reign. Which mostly means crying and feeling mildly suicidal at this point. I do not have this sickening urge to mutilate my body beyond recognition and repair any more. From the island of reason one can only watch the churning waters pass by and recognize the immense pain in it. The frustration. The rage. The desire to just end this torture and be done with it. It all makes perfect sense in some fashion. I could so easily submit myself to it still, lose myself to this immense trauma.

I do not understand why I had to give up over eight years of my life to get some basic surgery to fix a relatively small oddity about my body. I do not understand why I had to suffer years of mental and emotional torture and blackmail. I do not understand why I had to be raped and abused. I do not understand why I'm living in limbo at the moment, without a fixed place of residence. I do not understand so many things. Each is a black hole in my psyche, just emanating pure pain. Each is a trigger for another attempt by my subconsciousness to assault me with images of all that hurts me more than I can take.

More than anything I hope that the surgery next month goes well so that the medical chapter can be closed after eight and a half year. I'll take not knowing my genetic makeup as a necessary sacrifice there. I also hope that the public hearing later this year in the case against the VUmc's gender team gets a lot of media attention and results in at least some of the answers to the 'why'. Finally I hope to regain access to my possessions again without too much mental anguish.

Finally, I hope to find enough peace outside and inside myself after all that to be able to just live. I'll gladly never be assaulted by my own mind again.

Here's to an exceedingly boring life.


Saturday, 22 June 2013

Game Review: The Last Of Us

This is a review of the video game The Last of Us, released in June of this year. I watched a full play through of the game by a YouTube user by the name of NukemDukem who played the entire game on the Playstation 3. I picked his play through because of his focus on exploration and absorbing of the story. The play through was watched by me over the course of a few days. The following review contains massive spoilers and complete story and plot dissections. Do not read it if you don't want to have the game and/or story spoiled for you.

Moving on with the review, I first caught a glimpse of this game before E3, when the demo for it was released. Watching videos of people playing through the demo I didn't really feel too tantalized by the story scraps being shown, not even by the trailer reel thrown in after one finishes the demo. It seemed like an okay post-apocalyptic world survival game. Then I watched the first first play through video containing the entire introduction section of the game.

The video starts off innocent enough. You are Sarah, the teenager daughter of Joel, an apparently single father. You are waiting for him on his birthday with his gift, waiting for him to come home. eventually you have fallen asleep and that's how Joel finds you. After some friendly bantering you give him his gift, which turns out to be a watch. To replace his old, broken one, you say. It being very late, you retire to your bed.

Waking up suddenly by noise, it turns out that your uncle Tommy is trying to contact you on your phone, asking for Joel. Getting up, you find Joel's bedroom with the lights on but otherwise deserted. Downstairs nobody can be found either, just Joel's phone which is being spammed by Tommy, desperately trying to contact him. Just as you get to Joel's study, the sliding doors to the garden open and Joel stumbles inside, desperate to get the door closed again. With a smack the neighbour runs into the glass. Joel yells at you that it's not really the neighbour. Not any more.

You caught something on the TV earlier, about massive riots and violence in the city. As an explosion rocks the camera, the feed is cut off. In the distance, towards the city, you can see smoke rising up. It all begins to eerily make sense. There is however no time to dwell on all this. Joel and you run outside where Tommy just arrived with his car. Getting inside, the three of you try to escape the madness that's beginning to swallow the city. Encountering hordes of frightened people, running away from something, it suddenly becomes clear what they are running from: a horde of overly aggressive people. As cars from other people trying to escape begin to collide, your car is caught up in it as well. After coming to, the car is wrecked and you have to get out of the car.

The control now switches to Joel, who has to free Sarah from the car wreck. Together with Tommy they make their way through the crowds, trying to find safety. The enraged mobs are chasing them now. Passing through a restaurant, Tommy volunteers to stay behind to give them a chance to escape. After a brief moment Joel and Sarah leave. Shortly after leaving the restaurant, they encounter a soldier. Upon approaching them, with Joel carrying Sarah, the soldier contacts command on orders. He listens, then comments that there's a child among them. After a brief pause, he confirms the order and raises his rifle. Joel begs him not to shoot, but to no avail. After a short burst, Joel lies on the ground with Sarah nearby. The soldier moves towards Joel, clearly intent on finishing the job. Joel begs him not to do it, but there's no hesitation in the soldier any more. Then a shot rings out and the soldier collapses as Tommy rushes in to assist.

Joel seems to be fine, but as he rushes over to Sarah, he finds that she has been mortally wounded. Unable to speak a single word, Sarah's strength slowly fades as Joel desperately tries to save her.

Twenty years later, Joel is living in a quarantine zone in Boston. The events of twenty years ago were caused by a fungus infecting people, taking over their brains and slowly mutating them. Contact with the fungus spores or the infected leads to infection. Most of the US has been turned into a wasteland as a result. Joel works together with Tess, a woman who like him has become a smuggler within the zone, whether legal or illegal. All to survive. While settling a score with another trader who has betrayed them, they come across Marlene, a leader of the Fireflies, a resistance group who want to break the rule of the US military over the surviving people. She wants them to smuggle a girl out of the city to meet up with another group of Fireflies. Eventually Tess and Joel agree to this.

The girl is 14-year old Ellie. She is was raised by Marlene after her mother died. Initially upset that Marlene isn't accompanying her, she eventually agrees to follow Joel and Tess. The latter do not know what's special about Ellie. This is revealed a bit later, when things of course go south. They find that the group of Fireflies was slaughtered by soldiers and are haunted themselves. Tess sacrifices herself to allow Ellie and Joel to escape, after revealing that she was bitten by an infected an hour before that. Her life is forfeit anyway. During the same scene it is revealed that Ellie is special because she is apparently immune to the fungus. She was infected weeks ago, while normally 2 days suffice for a full infection. Tess wants Joel to take Ellie to the Fireflies, to get a cure and save humanity.

Many things happen after this, including memorable encounters with characters, either in-person or via letters they find. Henry and his brother are particularly memorable. As Henry's younger brother becomes infected and has to be shot (by Henry himself), Henry can not take this and raises the gun to his own head before pulling the trigger. They also encounter a group of cannibals, first at the university where they had hoped to find the Fireflies, then again after Joel gets injured and Ellie has to go out on her own to gather food. She gets captured, but manages to escape. Eventually Joel finds her again, just in time to see her put an end to the life of the leader, who was apparently just on the verge of raping her. The savage rage with which she stabs into him with the knife she holds definitely suggests this.

The story quickly culminates to the ending hereafter. They end up at the St. Marie's hospital in Salt Lake City, where the Fireflies have taken up residence and are continuing research to find a cure. Upon encountering a Firefly patrol, Joel is knocked out cold. Waking up again, he finds himself on a hospital bed, with Marlene sitting on a chair next to it. She explains what has happened in the mean time and also that Ellie will provide the cure for sure. Somehow the fungus which has infected her has mutated so as to be harmless. If they can figure out how this happened, they will have the cure. As Marlene explains that Ellie is being prepped for surgery to remove the fungus and that Joel can not see her, realization dawns on him that since the fungus grows on the brain, they can not remove it without killing Ellie.

Marlene orders the guard to escort Joel outside the hospital and to shoot him if he resists. Joel manages to distract the guard and kills him in a savage way, similar to how he killed the two members of the group of cannibals who he questioned to get Ellie's location. After this he goes on a rampage through the hospital to free Ellie. Finding her in the operating room, he kills the surgeon with a single shot as he threatens him with a scalpel. Heading down with the elevator to the parking level, the doors of the elevator open to reveal Marlene standing there with a gun. She begs him to reconsider his choice, as this could save so many lives. Ellie is hereby still completely knocked out by the drugs given to her. Joel refuses and shoots Marlene, then puts Ellie into a car and drives away.

The closing scene is with Joel and Ellie finding their way blocked so that they have to abandon the car. Hiking a short bit, they come upon the town Tommy and his people have been setting up near a small hydroelectric dam. They had visited it before, where Tommy had shown his vision of rebuilding civilization. Asking for his attention, Ellie asks Joel whether everything he had told her about the Fireflies is true. Joel responds affirmative.

What Joel had told Ellie was that the Fireflies didn't need her, that they had found dozens others like her, and that no cure had been found.

One thing I definitely have to say about the story of The Last of Us: it's a lot to take in. There's a massive roller coaster ride you will go through, with many turns and twists. While none of the plot twists are major, the ending nonetheless wasn't easy to see coming. There is also a huge variety of events throughout the game, which makes one feel like they actually contribute to the story instead of merely acting as padding between the cutscenes. Graphics-wise the game looks very good despite running on such old hardware (2006-era PS3). Sound design is very good too, with subtle environmental effects and a distinct lack of background music. The result is a very immersive experience.

What most people including me felt rather conflicted about is the ending. Would Ellie's death really have brought salvation to humanity? Was Joel's lie to Ellie okay? Was Marlene simply misguided, evil or did she really have the best plan for humanity's long-term survival? Looking back at the whole story, I think that there really were only two choices: that of Ellie's certain death and the uncertainty of a resulting cure, or the fragile but conceivable attempt of restoring humanity to its former glory via settlements like those of Tommy. Instead of locking themselves away into quarantine zones which slowly disintegrated, got overrun and were abandoned, these settlements would focus on the future, on restoring the world for humans to what it used to be.

As Tommy says to Joel and Ellie before they leave for the university looking for Fireflies says as they look out of the settlement with its burning electric lights, the children will be watching movies tonight. More normal than that doesn't get it, compared to the madness of the crumbling world outside the settlement.

Even if what Joel says to Ellie is a lie, it's a white lie as far as I'm concerned. Ellie is already torn up over everything that has happened and everything that she has seen. She doesn't need more guilt and doubt about whether her death could have meant the cure. Throughout the story Sarah's death slowly comes to the foreground, as Tommy's wife tells Ellie about it and she figures out that it is part of the reason why Joel behaves so oddly towards her at times. Not having accepted Sarah's death, Joel is torn up by it inside still with the wounds still fresh and bleeding even after twenty years. In a sense Ellie's presence and how they become closer and closer provides the healing experience he needed to accept what happened so long ago.

In some ways this story comes round to meet itself at the end. It started off with Joel and his daughter Sarah and ends up with him and his more or less adopted daughter Ellie. Only this time there is probably no apocalypse waiting. It's the second chance Joel has been waiting for all this time, and to Ellie the hope for a stable existence which she has never known in her short life.

It would have been interesting if this game had had two endings, allowing the player to choose between having Joel leaving the hospital at the end, or rescuing Ellie, but in the end I think that such a thing wasn't the intention of the developers and would have degraded the overall experience. Yes, it's a video game and as such an interactive experience. It's also very linear and everything in it will always happen the same way no matter how often you try it. The point seems to be that you are allowed to live the story, in a way that a movie or book never could.

In that regard it seems to have succeeded masterfully.


Friday, 14 June 2013

Awaiting The MRI Scan And More Observations

Today I got a phone call from the local hospital I sent the request for the MRI scan to. They wanted to verify a few details before putting the appointment into the system. A confirmation letter will be sent to my current address via snail mail, which I will thus receive tomorrow. I'm hoping that the MRI scan will take place at least this month, so that the last surgery consult and the surgery itself won't spill too far into next month. It really gets pretty tiring to have all of this going on.

I can really say that since Monday I haven't been feeling myself, really. In as far as 'myself' ever was my self, if you catch my drift. As I mentioned in my previous post it's as though only now I get to fully go through puberty. The past few days I'm noticing this even more. For a few years I figured that I had grown up emotionally and would be comparable to a 16-year old on an emotional level. The past days that theory got thrown pretty much out of the window. Now that I am beginning to accept that I'll finally have my body back I am also beginning to realize that I can only now truly go through puberty. Before I was only pretending.

I never before truly noticed the mental blockades preventing me from feeling and experiencing certain things. I knew that getting the medical research and any surgeries performed to get my body into the state I felt was right, but I was never really able to express why this was important. For years I have been fighting in my experience against often well-intended comments that I should learn to accept and be happy with my body the way it is. Looking back now I can see the unimaginable damage those remarks have caused. Each of them tore away a little bit again of my sense of self-worth and determination. I'd never have to go through puberty. I don't need a self-image. I don't need to listen to these feelings about what'd make me happy. Just numb your feelings a little bit more and everything will be fine.

At the same time that I realize all that I also know fully well that it all doesn't really make a lot of sense rationally. I mean this whole sexuality business. Why waste so much time and effort on it, just for something whose use can be described in two words, those being 'pleasurable' and 'procreation'. The latter doesn't apply to me in any fashion since I wasn't born with any functional reproductive organs. The former is in my view very much debatable. Those who have read my previous posts know that I harbour a deeply seated hatred against sex, sexuality and couples. Maybe it's just that the way I was born and being prevented from going through puberty in any normal fashion fostered this hatred. Maybe the way physicians and psychologists further broke down my psyche together with the sexual abuse and rape I suffered over the past eight years prevented me from ever developing anything but sheer hatred and distrust on those topics.

Then why do I still want this surgery? Why do I feel this absolutely overwhelming need, nay, necessity to get a functional vagina? Maybe it's just that when one is born one has this mental template of one's body, of how it's supposed to be, look and function. Outside influences can tweak and distort it, but it'll always be there, driving one. If that's true then my drive for this surgery is simply to complete this template. It's what I'm supposed to be, look and function like. Maybe it's the final piece of the puzzle which will allow me to finally experience the emotional side of puberty, which is to say making lots of stupid mistakes in the areas of sexuality and dating to become emotionally mature enough to not make those mistakes again.

Maybe this is my last shot at the normal life I feel I never had. I was living in the wrong body all these decades, all because it didn't match up with my mental template. I couldn't find the 'me' in amongst all the chaos and confusion. It feels like a certainty now. Something solid. Something about which I can truly feel that it is me. This body. This mind. These thoughts. Nothing as trivial as the wrong gender either. This isn't about gender, but about existence. In previous posts I sometimes alluded to this, of this body I could see in the distance, but which I could never reach, despite knowing that it was my body. I felt that physicians and psychologists kept me from reaching it.

In the end all it took was the recognition of my body's physical state and a relatively minor surgery to create a new vagina entrance and labia. I'm a hermaphrodite. This is me. It's who I'll always be. It's how I was meant to be. This is right. This feels proper.

This whole process is making so much loose inside my psyche, it's astounding, I had never imagined I could feel like this, even though it is logical at some level. It's wearing me out at the same time, though. I'm sleeping more and more, and trudging off to bed before 10 PM feeling completely exhausted, sometimes literally falling over onto the floor, unable to keep my balance and almost too tired to get up again. It's probably a healthy process, but since I'm catching up on nearly three decades worth of emotional and mental luggage it's also murder on my mental and emotional reserves.

Here's to a well-executed surgery next month and the end of a major chapter. Then it's onwards to the first public hearing in the case against the VUmc hospital's gender team, scheduled for September 24th this year, and with it the confrontation with another major part of my traumas. I just hope I won't have to spend another eight years fighting that war. I'd like to actually do something useful with my life before reaching the half-way point of my body's lifespan. Experiences like I have had and still have make one far too bloody aware of one's own mortality and limited years on this world.


Monday, 10 June 2013

More Surgery Preparations Commence

Yesterday I was doing my utmost to not freak out about today's surgeon appointment. Today I would learn what the surgeon could see on the MRI scan images and what his prospects are on the results attainable by the surgery. Suffice it to say that a lot of thoughts were flashing through my mind, many of rejection fueled by eight years of mostly Dutch physicians outright rejecting me as being a hermaphrodite and having anything beyond a male physiology. It was in this state of trepidation that I embarked on my journey this morning to face up to my fears.

Three hours later I arrived at the clinic, just in time for my appointment. The big word came out pretty soon already. This surgeon saw the same things on the MRI scan as the three groups of German physicians. This means that his hope for the surgery is to recycle the scrotum skin for the labia and entrance of the vagina, while connecting the latter to the internal vagina. To get a better, more clearer picture of what the area he'll be operating in looks like he did want an additional MRI scan performed, this one with contrast dye to illuminate the different tissues.

The appointment was rather uneventful beyond this, aside from my sense of relief at realizing that despite my still many doubts this may actually work out just fine. Walking outside again after the appointment didn't feel like I had just left a hospital. The whole atmosphere at the clinic, while professional, is quite laid-back which really helps to put one at ease. Having found a surgeon whose insistence on making me happy with the best possible result definitely helps with that as well.

Today the weather really was different from last Thursday. Then it was very warm and sunny, with people everywhere, today only people who had business being outside did so as it was quite cold in the morning. Wearing only a thin jacket over my t-shirt, I really was feeling rather cold while making my way to the train station this morning. During the single transfer on the journey I was very glad I could get into the next train. After the appointment it was still noon but it was warming up rapidly. I didn't need to have my jacket zipped up to underneath my chin any more, which made the trip back quite a lot more pleasant.

During both trips I did have plenty of opportunity to observe people, and my responses and thoughts. It's only now with the preparations for my surgery progressing that I'm beginning to realize just in how far I have become distanced in an emotional fashion from the people around me. This isn't news, but that it's still so pervasive is something I am only noticing now. It started already when I was around five years old when my emotional growth began to grind to a halt as I became more and more alienated from the people around me due to the combination of my giftedness and intersex condition. With the work I'm doing now (senior software developer/engineer) I have found that the former has now a place which both I and my environment can respect, making it a gift instead of a curse.

My intersex condition has continued to be a curse, however. The thing I started noticing on Thursday at first and in the days afterwards more so is that of behaviour on my side which I would call puberal, or behaviour befitting a normally developing individual in its second decade. I never had cause to behave like that, or develop certain traits and realizations. There always was the subconscious realization or knowledge that it wouldn't matter anyway, due to how I was born. After getting mentally ravaged and abused by physicians and psychologists, and physically raped and abused by others, I had to come to the conclusion that there was no hope for me in that area any more. I'd have to cast off gender, sexuality and anything related to it.

This upcoming surgery seems to be giving me a second chance at going through puberty in a normal fashion. One in which I can develop a healthy self-image, where I do not have this burning need to get questions answered about my body, and where I'm not an easy prey for anyone who wants to take advantage of me due to having been turned into a trembling wreck due to years of mental abuse. I do not have to look at others any more and see them as a kind of alien race. Everything is becoming available to me now as well. It's almost like I'm becoming normal, instead of a social reject.

Reflections aside, today's events have managed to put my mind considerably at ease yet again. Much of the tenseness I felt before when regarding people around me is fleeting. I feel that I too can be respected, accepted and be a part of society instead of all the opposites. That I'll also be one of the more interesting individuals alive today feels fine too. It too feels like a normal part of who I am and should always have been, even if I had not quite imagined it to be like this all those years ago.

Moving on, I have sent the MRI request to the local hospital here and will await the appointment for the scan. After it I can make another appointment with the surgeon, who'll then probably decide to go ahead with the surgery. Hopefully next month this will all be over with. I know I can't wait.


Saturday, 8 June 2013

The Long Train Journey To Salvation

In yesterday's post I already described briefly what had occurred last Thursday, when I finally encountered a surgeon willing to do the reconstructive surgery I require. In this post I'd like to go more in-depth on that day and its events. Feel free to pause this post so that you can fetch something to nibble on :)

This story really starts well over eight years ago, when I first went to a Dutch hospital - the VUmc - to visit the gender team there. I had namely found out that I was likely intersex, probably a hermaphrodite. This I had deduced based upon the outward symptoms and my own experiences. Fast forward eight years later and the score is three German hospitals agreeing on me being a hermaphrodite and five Dutch hospitals disagreeing that I could even be intersex. Unfortunately for the latter group the Germans did their homework and an exploratory surgery in 2011 in a Hamburg hospital gave the final word in this epic, international struggle.

Even after all that I could however still not find a surgeon willing to take on a task I deemed very important. During the German examinations it was determined that I have in addition to the male anatomy also a partial female anatomy, specifically a vagina. Unfortunately said vagina is also closed off from the outside, which explains why I was marked as a boy at birth. As this probably also saved me from having either the male or female side ripped out while I was still an infant, this probably was for the best. It does mean that in its current state it's not a very useful vagina, however. Worse, by having it closed off any produced fluids and such will collect in there, conceivably leading to infection, inflammation and worse. Both from a medical and emotional point of view it's undesirable to leave it as-is.

Oddly enough it was virtually impossible to find a surgeon willing to help me with this after all that. Dutch physicians of course kept denying that I could be intersex even after the Dutch court approved my legal gender change to female last year. In other countries including Germany and the US I found no help either. After searching for over a year, I was ready to throw in the towel. Asexuality isn't such a bad thing, I reckoned. At that time, however, a friend read this article in a Dutch newspaper about a Dutch surgeon who does reconstructive surgery on African women who have suffered ritual circumcision. Contacting this surgeon on my behalf, the response was positive.

Initially I wasn't feeling too interested in giving yet another surgeon a try. It wasn't until the surgeon actually called me on my phone last Monday and invited me to make an appointment that I decided to give it a try. With my expectations hovering somewhere between careful optimism and bracing for outright rejection, I started my long journey to the clinic where this surgeon works.

Naturally, it wasn't the only thing I did that Thursday. I put in a two hours on this Android app project I'm rewriting and updating for the German company I work for. I then went to my first appointment of that day, hair-removal at a nearby beauty salon. Yes, that's still going on as well. Doesn't seem like I'll be rid of those treatments for a while either. Anyway, afterwards I caught the train to the clinic.

There's always the question of what to do during a 2+ hour long journey. In my case I had prepared myself well, with my ereader, pile of projects to work on and my smartphone to research items on the Internet. Also a few emergency chargers to keep said smartphone from dying halfway during the day :P Thus I arrived at my destination without too much trouble. GPS on the phone makes finding places in a city a snap these days. Once at the clinic the first snag came when I had to wait an additional one and a half hours past the original appointment time due to a surgery taking longer than expected. Truth to be said, I knew I was nervous because I had trouble finishing my breakfast that morning with little appetite. I still felt I had myself under control quite well. None of the hyperventilating I used to experience at previous hospital appointments.

I actually had interesting discussions with the other people in the waiting room. One of them was accompanying the person currently in surgery. With him I talked the most and eventually I briefly told him about my story and the reason why I was there. He seemed quite interested, so I gave him my business card for the address to my personal site on it.

Eventually it was my turn. The surgeon led me into an examination room. His first question to me was 'What can I do for you?'. The whole of the conversation which followed I can not recall in detail, just that he mentioned after that that he way he saw it I had a problem and it should be fixed. I couldn't agree more with him on that point. A physical examination followed, something I'll gladly do without for the rest of my life. I lost count of the number of times I have undergone one. This one was different, though. It didn't feel like he was the brilliant physician, examining a lowly patient, but more as though he was there... helping me, I guess.

His response to my physical appearance was also that he thought that I am a beautiful woman, and that everything about me, from my movements to my voice to my general appearance is just totally feminine. I felt flattered by this, while realizing that he probably had a quite different idea of what I would look like before he saw me that day. There also was another matter to make clear. During the physical he suggested that I would want to have the penis removed. I then said that I'd want to keep it, that it is a part of who I am. This didn't seem to startle or surprise him in any fashion as he just moved on with examining the area under which the vagina is located.

After the physical, he talked some more about the work he has done on those African women and how much joy it gave him to give them back the enjoyment of sexuality. To him that is something very precious. He made it abundantly clear that he intends to do the same for me. When he described it like that I felt a lot of warmth inside of my chest. Here was someone who genuinely wants to help me. Not just make something which looks like a vagina, but with all of the sensations that come with it present for as much as realistically possible. I could only thank him at this point. I honestly didn't have words to express how happy that would make me. It would finally give me back a part of me which was cruelly stolen and kept from me for all those years.

Moving on to practical matters, he needed to look at the MRI scans made before to finalize his planning for the surgery. I had tried to send them digitally before, but this seemed to give some issues. Due to this I promised that I would resend the scans once I got home again. After this I made an appointment to discuss the surgery planning for the next Monday.

Walking home again through the streets filled with happy people and a park with people sitting on the grass, playing and listening to music, I felt strangely elated. Nothing had changed yet, as far as I could logically determine, yet there was a sense of certainty about this whole approach now. Travelling back by train for another few hours, I felt strangely peaceful and focused. I was calm enough to do some research for an algorithm I need for an app I'm developing for an American company. It was actually somewhat enjoyable.

Arriving back at where I am currently staying around 10 PM I was pretty much beat. Having survived the day basically on a sandwich and some cookies, I ate a meal, then sent the MRI scans to the surgeon. After that I pretty much collapsed on my bed. Much like my smartphone, I guess, which survived with just 7% charge despite emptying both emergency chargers. Need to get a better one, I guess.

So there you go, my story of that day. Hopefully it'll resume on Monday with a positive planning for the surgery, with the MRI scans actually having been interpreted. The actual surgery should be soon after that, possibly still this month. In my previous post I already discussed the possible outcomes there. Of course I'm hoping for the best possible result. For some reason though, people seem to think it necessary to stab me with a dagger between my shoulder blades and twist it around a few times when they insist that it could very well end up being a major disappointment. Yes, that could happen, but you don't really have to crush my spirit like that. I don't remind you that you are possibly going to end up in the midst of a flaming, crumpled wreck with your loved one's dismembered head on your lap every time you get in that car. Please allow me the luxury of the thought that everything is possible and will likely work out. Thanks.

Anyway, it's going to be an extremely trying time for me until after the surgery when I'll finally hear the result. I'm actively trying not to think about it too much. Thanks to all my experiences the past eight years there's precious little I can take. This is my final shot at a regular life. Emotionally I'm worn so thin that if it were shoe soles you could look through them. I have good hopes that I'll end up with at least an acceptable result. This based on actual medical evidence of the past years, instead of baseless speculation such as that said dagger handlers.

I guess I'll quit before I start biting off people's heads :) I do know that I'm rather on edge due to all of this. On one hand it's all extremely positive, on the other hand it's also highly destabilizing. I really do hope I land on solid ground after all has been said and done.

See you all at the flip side.


Friday, 7 June 2013

End Of An Era, Or: Things Really Don't Have To Be That Difficult

I guess I still can't really quite believe it, even though it seems to be true. I have apparently slipped through a dimensional fold somewhere from a reality which was driving me crazier than Alice in Wonderland, into a reality where physicians actually exist to help people and not to inflict them with horrible psychological traumas. To summarize things very succinctly, I have found a surgeon who is willing to do the restorative surgery I need to regain use of my female side and it only took eight agonizing years.

Yesterday I went there for the first consult. As I mentioned in my previous post I was pretty nervous about it. While it was a long trip to get there, the consult itself was... how do I put this, pleasantly factual and to the point. I have a medical issue, the surgeon is, well, a surgeon. It's an issue he can resolve quite easily and it's a case which is unique to him, but the surgery itself is within his expertise.

Early next week I'll be heading there again for an appointment to plan the surgery, with the surgery likely to follow soon after. Since it takes place at a private clinic there are no long queues and no months to see a specialist or get a scan or treatment. With some luck I'll have the medical chapter of my being intersex story finished within a month. It all makes me wonder just why all the Dutch specialists I visited over the past eight years just had to make life so hard for me to the point where I had to spend nearly a decade of my life going through the horrible experience of knowing exactly what was going on and what had to be done about it, with not a single Dutch physician backing me up. Instead I got treated like I was spouting nonsense, and on multiple occasions it was suggested to me and my mother that I should be taken to the psychiatric ward for treatment. I was supposed to be delusional.

Now, after eight excruciatingly long years I get to look back and I don't know what to feel. Relief that it is all finally over. Sadness that I have lost all those years when there was no reason. Anger that other human beings whom I trusted betrayed me in such a horrific fashion. Frustration that I was so powerless and weak that I couldn't do more to help myself. Also the dawning realization that it'll take many more years to process the traumas of these years to a level where I can actually learn to live with them. I may have survived the war, but the war will always continue inside of me.

Some things are still a tad uncertain about the surgery. While it is known that I have in fact a vagina the surgeon won't know until he makes the first incision what the final result will look like. Basically in how far it will be functional like a fully developed version. The MRI scans are the best material to work with at this point and to prepare the actual surgery, but any surgeon knows that even the sharpest MRI scan can be deceiving or omit details. As for me, not until I wake from the drug-induced sleep and I am told the results of the surgery will I know whether I should feel overjoyed, happy, accepting or disappointed. I really do dread that moment.

First in Germany with the surgery in 2011 did I get the hope that this part of the surgery could be done, but the surgeon then had to disappoint me. Despite the vagina being visible after opening the perineum he was not able to do anything with it. The exact reason I wasn't told due to the language barrier, but I suspect it was a matter of specialization. In that regard my new surgeon should be perfect, with countless years of relevant experience. If he can't do it, it'll be very hard to find anyone who can do it. Even so, I'm crossing my fingers, toes and kitten ears that the news I'll get after the surgery will at least be somewhat positive.

Regardless, within weeks this chapter will come to an end. All one can do is hope for a happy ending.


Tuesday, 4 June 2013

The Twisted Paths Of Life

After this morning's news of one of my friends having become the victim of a road-side shooting and robbery, it feels weird for me to just continue with my own things. I know that he would want me to continue with my life, but it is clear to me that it will take some time for me to get over his death. It's definitely changed something inside of me.

Things are all a matter of perspective, and even the weather is very much predictable compared to the lives of some human beings, my own included. Yesterday I suddenly got a phone call from the surgeon who I thought had dismissed my case. He told me about the work he does, including for African women who have become the victim of female circumcision, and in the latter's case the pleasure he derives from them being capable of enjoying sex for possibly the first time in their lives. I'm not sure whether he really is the surgeon who will finally help me with resolving the medical issue of my closed-off vagina, but I am feeling strangely hopeful.

On Thursday I'll be heading off to meet this surgeon, with only a general idea of what to expect. I'm hopeful, sure, but also anxious beyond belief. Memories of eight years of previous experiences with physicians keep surfacing, along with the accompanying traumas. This joined by the fear that even if he does want to and can help me, he'll find that there's little or nothing to work with. I do not really know how well the vagina developed. The German radiologists mentioned that it looked pretty intact to them, but I couldn't get a clear answer out of the German surgeon who did the surgery on me in 2011, mostly due to the language barrier.

This all leaves me with not just a double, but more like twenty different conflicting feelings. Just throw in every name for every emotion possible and it's got to be in there somewhere. Hopeful, anxious, afraid, terrified, joyful, contemplating, glad, petrified, disturbed, and so on. In the background I'm feeling totally wrecked at this morning's news. I still can not think about it or talk about it without breaking down in tears. It's odd to really cry about another person, even if I do know why. It's an overwhelming sense of sadness. Different from the raw pain I felt and still feel about my own situation, but very bitter-sweet. On one hand the awesome memories of a wonderful person, on the other hand the knowledge of his gruesome death and the images my imagination adds to the descriptions provided.

It makes me more than ever convinced that the idea I first got as a teenager that we should have the technology to back up brains is the right one. It'd make a death just a major inconvenience. Unfortunately this is not a popular opinion I have. Even my own family has always ridiculed me for considering such a thing. To most people they seem to believe in the mantra of life and death being the same and inseparable. I vehemently disagree with this assertion. To me death is the anti-thesis of life, as it directly opposes it. Where there is light there is generally shadow, but shadow doesn't end light. Death ends life. Permanently. This is a major distinction.

Death is organ failure. Death is the cessation of cellular activity. Death is irreparable damage to a biological system. Death is the termination of brain activity. Death is one back-up away from being a setback, much like how a computer's hard drive crash means a temporary setback if a proper back-up has been made. It's a technological issue, not one of a philosophical or theological nature. Ironically having such an opinion can get you killed. Not that the threat of this will ever keep me from continuing my research on such technology.

On days like these I realize just how little I have changed in terms of convictions and goals even before I became a teenager. I have always held life and happiness dear, with the conviction that science and technology is there to make everyone's lives better. Maybe that is what has kept me going all these difficult decades, through an impossible puberty and the insanity and madness of the medical and political systems around the world. In the end a body is just a body; a machine which can be tweaked and tinkered with. Invaluable to the brain occupying it.

Here is to hoping that this will be the first surgeon who can make the medical madness stop for me, ending over two decades of emotional suffering, conflict and agony. No more uncertainty and despair.


Farewell Frekie, We Will All Terribly Miss You

This morning I got informed by friends that a good friend of mine, Freek ('Frekie') van Niekerk was shot and killed during what appears to be a robbery. He lived in South-Africa after finishing his studies in the UK. His family and friends, myself included, will all miss him terribly. You can read a news article about it (in Afrikaans) here:

For me this seems all so terribly surreal. I met Frekie online years ago when I was busy with fansubbing Japanese anime series. I know him as an always happy and cheerful person, who on many occasions has supported me when I was going through difficult times. Just typing this is extremely hard for me. Just thinking about it all causes me start crying. It's just horrible to realize how such a wonderful person's life was cut short because one or more individuals wanted to steal his laptop and phone. It's the most senseless kind of death, leaving all of us behind with a sensation of terrible loss.

I do hope they capture those responsible so that some justice can take place, but I realize all too well that we won't get Frekie back with this.

We miss you, Frekie.