Out of the Cage

Out of the Cage

More of my ramblings from my diaries over the time of Top Surgery October 2015

A week of not so quiet and restful healing later, life has a way of changing our plans at whim, and it did that with style as always, but I was back in Brighton for my post op. Had it worked? Everything is healing as it should. Staples out from the nipples; glad I had taken codeine beforehand, so it wasn’t that painful. No more itchy dressings and I only need to wear a binder if I go out to protect myself.

I looked in the mirror and I look a bit battered. But I can look at me and not hate what I see to the point of spiraling into dysphoria. For the first time ever I can do that. I still have a lot of healing to do but it is one huge step in the right direction.

For the last two weeks my emotions have been shot to hell. They are still shot to hell. I don’t have the words that sum up how I feel and yes that is frustrating me to bits – I am a writer and not knowing words that express the emotions is unheard of for me. Happy. No it is beyond that way beyond that. I am out of the cage now and it is awesome. That is the best I can do to sum it up.

My Thanks

It is only proper that I stop at this point and thank all those who have supported me this far. My deepest thanks go to Mr. Yelland and his team at Nuffield Health who made it possible. Also to Jenny, Misty and Lisa for getting me there and back for the operation and to Andy for being there for the post op. My boys for being my boys and keeping me going. Alf for being a real bro and staying with me until I woke up. Kayto for being the best friend a guy could have at 430am. Finally, to Caz for being my Caz and making me smile when I wanted to cry – I’m not easy to live with and you hung in there for me.

Top Surgery: Pre-med

The sun was shining on a beautiful September morning as I left home yesterday. Other than thinking good it isn’t raining I didn’t notice. My guts were full of butterflies and I could think of a million and one other things I would be rather be doing. In April this day had seemed so far away now everything felt suddenly very real. Pre-med day.

The journey down to Brighton was uneventful and the trains quiet giving me thinking space. Mentally, I was geared for a negative outcome to the day as it always is regarding the medical side of transition. This is one thing I cannot build my hopes up for them to fail so I do the opposite. Sipping my water I was glad to be alone for a while. I was meeting up with a friend between the two appointments, and I would need the support then whatever happened.

Walking out of Brighton station I began to feel the nervous nausea but found a cab and within minutes was pulling up outside the Nuffield Hospital. I sucked hard on my sugar free mint but really a mint is no substitute for a nerves ripped to shreds cigarette. Oh well, no point in hanging about I went in to the snazzy reception area and tried to appear calm and no doubt failed.

I didn’t have to wait long before a nurse fetched me and started the pre-med formalities of health history, blood tests, MRSA tests, ECG and blood and heart observations. For once my pulse was playing the game and she found it first go. She then looked at me and I thought “here we go she’s going to tell me something is wrong” but no all good to go.

My mate was outside waiting in the reception so he sat with me while we waited for the consultant. I can’t remember what we talked about; everything and nothing probably. Whatever, it worked, I felt calmer when I was called in to see the consultant.

He started talking about the surgery, the risks and things that could go wrong. Not sure what he thought when I said ‘so you going to do it then?’ He took pictures then drew a rough diagram (he’s no artist) of a breast and how he would remove it. Yes he said remove it at which point it all sank in – at last the chest is going to be a chest. I came out of his office on a cloud.

For so many years my breasts have made me feel nothing but the self-hate that has pushed me into the pits of dark depression – in ten days they are gone. A cloud, no I am walking on thin air. I am so grateful my mate took me back to the station. I am not sure I would have made it without him to keep me grounded.

The journey home was easy too, apart from a long wait at Reading. It gave me chance to grab a much needed coffee so not really complaining. Today, as I write, it is like I have had a rock lifted off me. The journey to me is real and is finally happening.


©JG Farmer 2015

FtM Terminology




One of the most common questions I get asked is what all the terminology used by transguys means. So a quick A – Z as it were.


Binding is the process FtM use to flatten their chests to create a male-appearance.

Bottom or Lower Surgery

Gender reconstruction surgery.

Chest or Top Surgery

Chest reconstruction surgery is the most common surgical procedure sought by trans men. The aim of chest reconstruction is to create a male-contoured chest.


The bilateral mastectomy method of chest reconstruction surgery that is effective for those individuals who have a medium to large amount of breast tissue.

Female-to-Male Transsexual (FtM, F2M, Trans guy, Transman)

An individual who was born in a female body but whose gender identity is male and who actively seek hormonal and/or surgical therapies to live in society as men.

Gender Confirmation Surgery (GCS)

A positive term for the various surgical procedures for FtM including sex reassignment surgery (SRS), chest reconstruction surgery (CRS), genital reconstruction surgery (GRS), hysterectomy and oophorectomy.

Gender Dysphoria

A psychological term that refers to the state of discomfort and mental anguish felt by transsexual and transgender people resulting from the incongruity of their physical sex and their gender identity.

Gender Identity

An individual’s self-awareness of their gender being male, female or something in-between.

Gender Identity Disorder (GID)

A recognised psychological and medical condition where an individual has been assigned a birth-gender and identifies as belonging to another gender.


An individual whose gender identity is non-binary and identifies as neither male or female but as something in-between, beyond gender or some combination of genders.

Genital Reconstruction Surgery (GRS)

The process of constructing a phallus/penis from an individuals own donor tissue, also known as phalloplasty or phallo, or metoidioplasty where the clitoris from its connective tissue to present in a more phallic manner.

Hysterectomy (Hysto)

The surgical removal of the uterus.


A condition where an individual is born with either the genitalia or reproductive anatomy that is difficult to label as male or female.


One of the methods used for chest reconstruction that is effective for individuals with small amounts of breast tissue.

Metoidioplasty (Meta)

The surgical process of releasing the clitoris from its connective tissue so that it presents on the body in a more phallic manner. Scrotal implants may also be added.


The surgical removal of the ovaries.


Packing is the process for creating a more male-feeling or look to the crotch.


Being read as male by others.

Peri-areolar (Peri)

A method of chest reconstruction that is effective for individuals with small to medium amounts of breast tissue.

Phalloplasty (Phallo)

A surgical genital reconstruction method using the individual’s own donor tissue to create the phallus. Scrotal implants may or may not be added.

Real Life Experience (RLE)

The period of time a transsexual person is required to live full time in the role of the gender they identify as before the medical gender reassignment process can commence.

STP Device

A device that enables the user to stand to pee at a toilet or urinal.


After transition an individual may choose to be stealth and not reveal their transsexual status.

Testosterone (T)

Testosterone is an androgenic hormone that is responsible for producing masculine characteristics such as facial hair growth, deepening voice, body hair growth and muscle development.

Transgender (Trans)

The umbrella term for individuals whose gender expression and/or identity differs from the conventional expectations of their birth gender.


The process of changing from one gender to the other.


An individual whose gender identity does not match their birth gender,

Vocal Mutation

Vocal Mutation

Well it happened and I did not actually notice. It took a couple of friends to tell me my voice had dropped to a deep growl. That was a couple of weeks ago. Now I am paying attention of course.

I am not being misgendered on the phone anymore. In fact there is not even a question on the other end of the line when they ask for Mr and I answer accordingly. As a poet I read out loud a fair bit so hearing my own voice change was never going to be a guarantee as I hear it day in day out. Listening to some of the recordings I make of course I can now hear it.

As I have never had a high-pitch voice I was not expecting a dramatic change nor was I expecting it yet.  At the beginning of January I had a raspy sore throat and my voice was cracking up and down a lot but of course I thought it was the sore throat causing it. The throat has healed and I am left with what my friend calls a growl, it does not crack at all.

I like how it sounds right now, it is a definite improvement on the non-descript husky tone of old that was neither one thing nor the other. It feels comfortable and I can live with it.



© JG Farmer 2015

I Don’t Think I am Man Enough

I Don't Think I Am Man Enoug


This is the first in a short series of writes on some of the emotional and/or psychological issues that can face a transgender person. As this is a personal blog I can only write from my own experiences so have left stuff I have not had to deal with until a later date if ever.

Finding a Partner.

Why this is the first issue I do not know but it is so I will go with it. There is someone out there who has heard me say the words I have chosen for the title of this piece, not once but several times. Their answer is I am more than man enough so I cannot and do not argue with that.

If I look back over life before transition I have had a few relationships and all but one of them would not have worked out as I was not connecting fully with the people involved as a significant part of me was deeply buried within my psyche. I regret the fact I have hurt people because I could not be myself, but equally they would not have been part of my life if I had been. I am in no doubt those I did get involved with took what they wanted from me so I do not feel guilt or shame about it anymore. The end of love hurts and we move on.

So what good does looking back actually do? It tells me what I do not want in a partner. In the past I subconsciously or consciously sought out people who did not push too deep into me or try to invade my space. I did not look for someone who wanted me as I did not want me. Love with that sense of self-perspective is somewhat lacking at best. To know love, to give it and receive it one must first love self and I did not love myself, quite the opposite. I am not saying I did not love the people I was with in the past, I did in my own way, the only way I could but it was not enough because I was not man enough to accept myself and value myself.

Now I accept myself for whom and what I am. The fear of rejection is always a problem not just for transgender, but being transgender makes that fear all the more acute. The person I mentioned earlier knows and has known from the beginning of my Trans status and just where I am at in my transitional journey. I am accepted for whom I am and although I still doubt myself at times I know I am man enough.


Love and light


No Return



Over recent weeks so many people have chimed in with what they think is wise advice about my transition. All in the same vein that there is no going back. Each time I hear it, I listen and try not to bite as in the main they are being kind. The fact is I am past the point of turning back. I passed it the day I walked into Doc M’s surgery and asked her to help me. All the thinking had been done.

I have lost count of the sleepless nights spent in anguish trying to escape the inevitable choice of going down the road of becoming a man. Yes I said inevitable as there was really no other choice as my emotional and mental well-being was deteriorating rapidly. That anguish and pain I never shared with anyone. It is not something that just quietly crept through the door like a good idea. It has haunted me in some way since childhood.

Each time I pushed it back refusing to give in. Each time that got more difficult to do, until I could not fight anymore, not for her. She had reached the point of exhaustion and he had to take over. I have no regrets here. My life as she built him up until he was ready to take over and face the journey that will take me through this.

Mentally and emotionally the transition has taken place and has been going on for many a year. The times I feel like I have killed her, are the times I need to reflect on all that she gave me and yes my life as she gave me a lot, not least my wonderful sons. Nothing, not even he, can take their mother away but he does not want to as they are as much a part of him as they were of her.

Yes I know there will be no going back once medical intervention has taken place but in my heart in my mind I cannot go back as there is no place to go back to. As I sat in the guy from the Laurel’s office on Friday answering his questions, answers that go back to the 1970’s I felt the boxes of myself being unpacked – again. This is something I hate doing as it tears into my core. I cracked up a few times and despised myself for most of it.

This is nothing new, my LIFT counsellor and my psychiatrist have done the same thing a fair few times. It does not get easier and it does not get harder. Each time it is like opening up the wounds of self-hate and guilt for the first time, it hurts and it bleeds. I see the person asking me the questions and they are always kind and supportive but my barriers rise and I feel alone and haunted. Each little event of the past is like ghost reminding me of things I do not want to remember.

There is no going back as this time I am repacking those boxes and I do not think I will need to open them again. They are the events that hurt me and reliving them causes me the greatest agony I have ever known. Instead I am ready to move forward into the future and take all the crap and the good times that has to offer. This time I am aware it is those past events, and surviving, them that has made me stronger and ready to do that.

Once again I send my deepest gratitude to all of you who message me; your support is valued more than I can ever say in words.

Love and light


Getting In Shape


The male body shape may seem a distant dream and I have little option but to wait on the NHS doing its thing at its regulated pace of a dead snail.


Meanwhile …

I refuse to think negative and succumb to the ‘there’s nothing I can do’ mind set. So what can I do?

For the last six months I have been swallowing a whole heap of dietary vitamin and mineral supplements that are recommended for boosting testosterone. I am huge on alternative medicine anyway so finding a natural solution would make me a right happy bunny. Can it really be done? I guess the answer is yes and no. I can see a difference in how the facial hair is growing and it is certainly thicker and longer than it was but the much longed for moustache is not happening.

I have also started a diet and training regime. I need to shed weight anyway and body working with weights will build more defined muscles. I enjoy working out anyway it gets me pumping for the day. Diet – well that means I have to eat more oddly enough as dysphoria and stress both kill my appetite meaning I rarely eat more than one meal a day and that can be a strain. Now I am working out again my metabolism wants fuel so this where my battle with self is now. So far I am winning and have lost a few inches except on the place I really want to – the chest. Always the way it is, hence I let myself get bigger to hide the damn breasts in the first place.

Other news, I received a letter of diagnosis from the psychiatrist I have been seeing. Unbeknown to me he is a TG specialist and confirms I am and have been experiencing gender dysphoria and meet the diagnostic criteria for transexuallism. He recommends treatments to make the physical appearance congruent with my male ‘sexual’ identity commence as soon as possible. Okay I am not happy with sexual identity as it is gender identity, sexual identity is something completely different but it is the confirmation I have been waiting for so I ain’t complaining any.

Again I want to say a big thank you to all of you who read and support me with messages and comments. You do make a huge difference.


Love and light


And a little bit of 80’s nostalgia because I like it

A Wild Romance?

I am transgender, a man who was born in the body of a woman. I am in transition leading to my full male potential. Part of that journey has been to research all the possible outcomes making myself aware of what can happen, what may happen and what will happen.

Quite early on in my research I read up on the relationship between testosterone therapy and sexuality. Whilst there is no scientific correlation between T therapy and sexuality there is no guarantees that say post-T my sexual feelings will be the same as they were pre-T. However there are a sizeable proportion of trans guys who do experience a change in their sexual feelings and attractions.

As a woman identifying as a lesbian I am not totally unaware of what happens in other types of relationships so part of transition is to prepare myself for what may or may not be. Human sexuality is a complex thing and in some ways just as fluid as gender can be. It can be affected by how we live and feel about ourselves. As a trans guy I am not happy in a woman’s body and that may have numbed my desire to explore my sexuality fully.

T-therapy changes body appearance such as muscular and body fat distribution, thickened vocal chords, facial and body hair and so on giving a more masculine appearance and the trans guy feels more at ease in his body and himself.

Of course whatever happens as either a gay or heterosexual man I am in a new sexual territory and there is no getting away from that. One would assume I would be hetero as I identified as a lesbian – unfortunately it is not that predictable. My sexual roots being LGB do not make either very easy to accept. Whether that is because there is a level of prejudice within the LGBT community towards the trans person I cannot say.

The key for me is my inner belief in love knowing no barriers whether it is gender or something else. That alone makes whatever may be what it should be – gay or straight it matters not!


My thanks to all that message me, your support is awesome and means the world to me


Love and light


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Dysphoric Tears

Dysphoric Tears

The last few weeks have been somewhat testing emotionally. The intense feelings of displacement are coming fast and hard. Last week I was asked how I deal with it so that is what I will write about here.

Dysphoria is a way of life for me and has been for years to varying degrees. In the past I would bury it or let the depression run riot, mainly because I had no idea how to deal with it. The doctor would hand me a prescription for antidepressants which made me more depressed as deep down I knew they were not an answer, not even close to an answer. Endless counselling sessions focussed on life events which really had no relevance didn’t help either but gave me a way to distract from the real issue of being transgender. I would even convince myself the problem was in fact the issue being discussed. In reality it was another burying technique allowing me to distance myself from the abnormity of being me as I saw it then.

Now of course, I know without a doubt I am transgender – the labels of genderqueer, neutrality, and butch dyke are no longer straws I can clutch onto and hope they are enough to pacify the man within. The way I think, feel, act and present is male; it feels good, it really does. Then I remember the bulge in my jeans is a prosthetic and the constant ache in my chest area is a binder squishing the unwanted breasts.

It is what it is and the only way to deal with it is to take a deep breath and focus on it being a temporary thing. I made the big step and I am on the journey, but it is a painfully slow one. Very much like a roller coaster the going up to the peaks of something happening takes an age then when it does happen it is a whizz down to the next trough and climb. That is the NHS and there is little I can do to change it.

However, knowing it will happen in time helps deal with the dysphoria so I can get on with living. It would be easy to put life on hold and wait for the NHS to get on with it but then I am wasting six years or more of my life and I am not going to do that.

The fact is life was testing at times before and it will be after, so the times it is testing now are no different. I really believe it is these things that ultimately make us stronger. The going may get tough but that just means I need to toughen up a bit.

Again I wish to thank all of you who have messaged me with support, I really do appreciate it.

Love and light


One Week to Go

one week to go


A week has passed since the letter hit the doormat and now there is only one week until the first appointment. In some ways it seems so far away – a whole seven days. In the same way that Christmas seems distant to a child on Christmas Eve I suppose. And yes that is a good analogy as I do have that childlike, innocent sense of wonder about what is going to happen and like a child no doubt the actual event will be disappointing after all the anticipation. I am prepared for that.

However I was not and am not prepared for the more negative emotions of fear, abject fear. I am even having crazy nightmares that I cannot explain. The best descriptive I can come up with is horrific and bizarre images flashing in to what starts of as a normal everyday dream and ends up in blood and guts with me falling apart. It is the nightmare the professionals refuse to hear me and tell me I am wrong – and I know that is my big fear and it has no basis apart from lack of logic when sleeping.  I do not suppose that will be much of a problem this week as I know my psyche is edgy so sleep will not be easy.

With all this self-doubt kicking in and I know it is just pre-appointment nerves when all is said and done, I tested myself this weekend and went out fully presenting. I normally wear a binder but have not gone out wearing packing for a long while. And really no one notices you are wearing one but I knew. Previous experience with this has been one of feeling incredibly self-conscious and uncomfortable but not this time. This time I felt it there and it gave me a real sense of confidence in myself as a guy. That alone gives the use of packing a real purpose and a justifiable one. I do not have someone holding my hand saying all will be okay so I need to lift my own confidence levels in whatever way I can.

I need to be single right now because this stage of transition is very selfish in that the decisions I make now only affect me. They are decisions that will be hard enough without the added worry of how they could affect a partner. I cannot be pressured into feeling I must or must not do something because of someone else’s feelings. I am committed to staying single and that for the time being is as good as any marriage vow. I owe myself the same loyalty and freedom to be as I give those I love – yeah about time I worked that out really.

There is a week to go and I will update after the appointment – who knows things might make more sense – well at least a little bit. Thank you for reading, and as always your thoughts, comments and questions are welcome either in the comments section or via the contact me button.

Love and light




© J Farmer 2013