Naked


Three years after my bike accident, following "top" surgery in an out-patient clinic to remove breast tissue and reshape my chest in a masculine way, when I looked like a man but had undergone no lower surgery, I once again found myself in a hospital, this time for back surgery.

I had been forced off work and onto medical disability by a ruptured spinal disk, which left me in constant pain and unable to walk without a pronounced limp. Drugs, physical therapy and a spinal epidural had all proven ineffectual at treating the injury, leaving back surgery as my final option.

I was scared. While my surgeon considered the procedure routine, any surgery carries risks, and this one included paralysis from the waist down and possible loss of bladder and bowel control. Contemplating this, and the fact I would be under general anesthesia and therefore completely at the mercy of the surgical team, I sat down for a one-on-one discussion with the surgeon's chief nurse ten days before entering the hospital.

The surgeon knew I was transsexual, but as I'd only decided that day to go forward with the surgery, he hadn't had a chance to inform his nurse. I wondered to myself, was disclosure necessary? With back surgery, maybe they'd only strip me down to my boxers, in which case no one need know I wasn't a "normal" male. I thought about this as the nurse asked me a series of routine questions about my health, including confirming I was on testosterone without inquiring as to why. When she finally asked if I had questions, I took a deep breath.

"Yes,” I said. “First, will I be unclothed during the procedure?"

Across the expanse of her large, polished wood desktop, the nurse looked up from my thick medical file. Ramrod straight, an older woman with just the trace of a German accent, she nodded. "Yes.”

"Oh…." I said. “Then you won't be leaving on even my underwear?”

"No.” Her tone registered the slightest impatience. “You will be completely naked."

“Oh.” I slumped down a bit in my hard, straight-backed chair. "Well then, there's something I have to tell you."

I took a deep breath. Then, "I'm a female-to-male transsexual and I haven't had lower surgery. You say I'll be unclothed during the procedure, so I want to make sure the surgical team and after-care nurses and everyone else are all informed ahead of time, to make sure they’re not surprised..."

I trailed off. I could see I’d lost her at the word "transsexual." She was hefting my medical file, a blank expression on her face and as I watched she dropped the file over the edge of her desk and onto the floor by her feet. It almost seemed like a deliberate action, though I knew it wasn’t. She bent over to retrieve the file, grabbing a confusion of papers and pages which she dumped in a pile back on her desktop.

"Oh," she said, avoiding my eyes while she tried to stuff the unruly mass of papers back into the file-folder. "Ok…Well, that's fine. I…I don't see any problem."

I watched a crimson blush climb her pale features as her hands scrabbled with the papers, thinking I'm really glad you're not monitoring my anesthesia level right now.

Then I tried again. "I wanted to tell you this now,” I said, “because not everyone has a positive reaction to the information and I don’t want them to be distracted or upset while they’re supposed to be taking care of me."

She cut me off. "But you said you haven't had the surgery yet.” She scowled, as if I was intentionally trying to ruin her day. “So I don't see what problem there is!"

I suddenly realized the words "female-to-male" had slipped past unnoticed in her reaction to the word, "transsexual." As was true for many people, the existence of females who transitioned to live as men was clean off her radar screen. She had assumed I was male, transitioning to female, saw I looked completely masculine and wondered why in the world a lack of surgery would pose any challenge to her staff.

I sighed again. Leaning forward in my chair, I annunciated very slowly and distinctly. "I have no penis."

Her jaw dropped. "You?! What? …Oh!” She inhaled sharply and sat back in her chair. Comprehension slowly washed over her features and, though I hadn’t thought it possible, she blushed even redder. "That...the…then…that explains the testosterone."

"Yes," I said, squaring my shoulders. And, as was my strategy in situations where someone was reacting badly to my disclosure, I adopted a calm, sympathetic demeanor. Treating the whole thing matter-of-factly when it obviously wasn’t exhausted me but it tended to take the wind out of the sails of over-the-top reactions.

"Do you understand now why I'm telling you this? It's not that I want to make you--or anyone--uncomfortable. I just want to make sure that everyone can focus on doing their jobs--on taking care of me during surgery. I don’t want them to be caught up in their reactions because they suddenly realize I'm ...different."

"Yes. Yes, I understand now. Of course…of course, I understand." The shuffling of papers slowed as she began to regain control of herself.

I, on the other hand, was shaken. Her meltdown had unnerved me.

After I left that day, I considered delaying the surgery and trying longer to heal my injury with physical therapy. The prospect of, say, my surgeon’s assistant or someone tripping on the physical reality of my body and oops! making even a small mistake, terrified me. I found it hard to shake the vision of the highly trained and experienced nurse reduced to a stammering klutz by my mere spoken revelation. The physical reality of my body was even more dramatic.

Walking abroad in the world possessing what looks like (while clothed) an intact male body, everyone assumes that I have all the expected plumbing. This expectation, needless to say, sets up a tension in my day-to-day existence. I never forget--indeed, society’s insistence on a two-sex system and its discomfort with transsexuals ensures I never forget--that I am different. I live one traffic accident, one false arrest, one ill-chosen confidence away from embarrassing--and possibly lethal--exposure.

One such case of an exposure gone wrong occurred on Christmas Eve, 1993. Twenty-one-year-old Brandon Teena was raped and, a week later, brutally murdered in Falls City, Nebraska, by two companions who discovered that their “male” friend actually possessed a female body. The small town sheriff Brandon turned to for protection was more interested in lurid details of the crime than in arresting the known assailants. His inaction gave the rapists time follow through on their threat to kill Brandon if he went to the authorities.

Word of Brandon’s murder spread like wildfire through the ftm community. On the verge of my first shot of testosterone, I knew that it could have been me. Murder of us is so widespread, frequently accompanied by sexual assault and a viciousness born of extreme emotions, that activists have informally coined the phrase, “the transsexual death penalty.”

I decided to call the nurse back a week later and feel out how she was adjusting. Keeping my voice nonchalant, I asked if she had any questions for me. Any concerns?

"No,” she replied, “none at all."

She sounded a bit nervous but generally under control. I reiterated that my main concern was that no one be distracted from doing his or her job, and she told me to rest easy: her staff were professionals and they would perform their jobs skillfully and well. We finished our conversation and I hung up.

I sat there staring at the phone, my hand shaking slightly on the receiver. At the time, I was living in a second-story flat in the Mission District of San Francisco. My four housemates consisted of two "boy-dykes," a fem lesbian and another ftm who was my best friend. They were at their various jobs, so I had the large, run-down Victorian to myself. Sun splashed in through the windows overlooking Guerrero Street, and I listened absentmindedly to the shrieks and laughter of children at recess at a nearby Catholic school.

What should I do? I wanted to call back and cancel the surgery, but what then? As it was, I couldn't work, couldn't walk much farther than a few blocks at a time, couldn't even cook for myself or do dishes or other household chores. If I canceled now and didn't get better, wouldn't I run the same risks if and when I decided to reschedule the surgery? I felt a flash of resentment. Why should I have to worry about this on top of the risks of the surgery itself?!

Finally, I removed my hand from the receiver and levered myself up out of the armchair and onto my feet. I'd done all I could to make sure my surgery would go well. Now, best let go of my worries and proceed.

Fortunately, the surgery was successful beyond anyone's expectations. Members of the Kaiser surgical team treated me with kindness and respect. The nurse who rolled me into the operating arena pointed out brown paper covering the room’s plate-glass windows. "For your privacy," she said. "Just like we do for our own."

Flat on my back, already feeling the effects of the drugs they'd pumped into me, I was more relaxed than I'd been in a long time. Surgery-smurgery, I thought, bring it on!

They told me to count down from 10: I was out by seven.