To give a brief personal history, I am currently 43 years old, 5′ 7″ and 137 lbs. Transition officially began on my 40th birthday in June of 2001, when I decided to make reality of the cliche “Life begins at 40″. Psychiatric therapy began in May 2002, and cross gender hormone therapy officially began in August 2002. The following year was mainly focused on creating “Miss Susan”. In July of 2003 my name and legal records were changed to reflect my new persona. On October 30, 2003, I received the first psychiatric letter of recommendation for SRS.

In the Beginning
On Saturday, November 8, 2003, I submitted a request for SRS information at the website of Dr. Harold M. Reed with little hope of hearing back from his office anytime soon (ye of little faith). At approximately 7:00 PM that same evening, I heard the answering machine activate and a voice stated, “Hi Susan, this is Harold Reed.” I couldn’t believe it! I jumped up and ran through the house like a bull through a china shop trying to get to the phone in time. This seemed completely unprecedented to have a surgeon personally contact me, especially on a Saturday evening. Most doctors would have a receptionist get back to you at a later date.

Our conversation was quite pleasant; however, I was made well aware that SRS was not going to happen anytime soon. Several challenges still remained. Genital electrolysis was required, as well as an additional letter of recommendation from another psychiatrist. I also needed to gain 15 to 20 lbs. I attempted to envision the journey that lay ahead and remembered a small plaque on my therapist’s desk that stated “Determination is remembering what you want”.

The next several months were spent undergoing genital electrolysis. I found another psychiatrist through the recommendation of my physician and began increasing my diet in an effort to gain weight. From time to time questions arose, and I would contact Dr. Reed via e-mail for advice. Dr. Reed always replied in a timely manner, and his responses were always very informative and compassionate. On March 30, 2004, I received a second psychiatric recommendation, and genital electrolysis was nearing completion. It was time to contact Dr. Reed to secure a date for SRS.

Dr. Reed thoroughly reviewed all pre-surgery requirements with the mutual understanding that there would be no deviation from his instructions. He once again stressed the importance of increasing my weight to 150 lbs. We scheduled May 14 as the date for SRS. Shortly thereafter, however, I had to reschedule due to conflicting travel arrangements. Dr. Reed advised me to contact Anne to reschedule.

Anyone who has encountered Anne would surely agree that she is truly a descendant from heaven. Upon calling the Reed Centre Monday morning, Anne warmly stated, “Hello Susan, I’ve been expecting to hear from you.” Suddenly I felt as if I had known Anne my entire life. Towards the end our conversation I asked Anne’s advise on the correct fitting of anti embolism stockings. Anne asked if I had large legs and I replied, “No, I have bird legs.” There was a brief moment of silence, then Anne finally replied, “Bird legs?” We both started laughing and on that humorous note, we set the surgery date for June 11.

An Uphill Journey
May 2004 finally arrived and I was eagerly anticipating June 11. Time somehow seemed to be slowing down as my anticipation increased. The medical clearance exam was scheduled for May 21, and was to include a complete blood analysis, chest x-ray, stress EKG, as well as a letter of medical clearance from my physician. Just prior to the medical clearance examination however, I was informed the stress EKG needed to be performed at a local hospital. I quickly attempted to schedule an appointment with a local hospital, only to be informed they performed no such procedure. The hospital advised me to contact a cardiologist. I contacted a local cardiologist and was informed they needed a requisition from my physician before a stress EKG could be scheduled. I contacted my physician’s office only to be told someone would get back with me later. This was becoming a merry-go-round, and I finally called Dr. Reed for advice. After explaining the situation, Dr. Reed simply said, “Let’s do a 3-way call right now.” Dr. Reed called the cardiologist, faxed him a requisition, and scheduled a stress EKG appointment for May 25, all within a ten minute time frame. I was completely astounded! Never before has any doctor ever gone to such great lengths for me.

The medical clearance exam indicated excellent health, and my physician proceeded to write a letter of recommendation to Dr. Reed. The stress EKG indicated equally good results. My mother would be accompanying me to Miami for the procedure, and we confirmed our reservations at the Bay Harbor Inn. All that remained now was Dr. Reed’s final review of the medical records, and I was confident there would be no complications. Memorial Day weekend passed by, and all I could think of was June 11. Time seemed to be at an absolute standstill. By June 2, however, I had not heard from Dr. Reed, and I decided to call to make sure he received the medical records. Vladimir informed me that some records had arrived, and he would have Dr. Reed contact me ASAP.

I received a call from Dr. Reed that same afternoon, and he informed me he was having some reservations regarding the surgery. Dr. Reed first indicated there was a discrepancy in my height that needed to be clarified. I am only 5′ 7″, but the medical clearance report stated I was 5′ 11″. He also mentioned my weight was still too low. Dr. Reed then stated the CBC indicated low blood levels. He explained this could pose a dangerous risk factor as there would be no reserve in the event that I started to bleed. He further explained there were two treatments typically used to remedy this situation. The first treatment utilized Procrit, which could cost at least $600.00 per injection. The second treatment utilized testosterone, which only cost about $15.00. Dr. Reed’s initial recommendation was that I contact my physician and arrange to begin injections of testosterone.

I awoke early June 3 at 4:30 AM after a very long, restless night. There was so much on my mind. It was my birthday, but all I could think about were blood tests and testosterone. SRS was only eight days away. A beautiful full moon was casting delicate patterns of moonlight through the trees into the bedroom window. I finally crawled out of bed, located my telescope and digital camera and ventured into the warm, sultry Florida night. I took several photographs of the beautiful June moon. It was then time to get ready for the day ahead.

Dr. Reed faxed the necessary paperwork for the CBC, and I proceeded to the blood lab. The blood analysis was performed quickly, and the lab technician assured me she would fax Dr. Reed the results ASAP. After the blood test, I stopped into a nearby restaurant for a quick breakfast and then proceeded on to work. As I turned into the parking lot I noticed Dr. Reed had been trying to call. I immediately returned the call and Dr. Reed answered the phone. He informed me he received the CBC results, and the blood levels dropped even lower than before. Dr. Reed then told me to contact a board certified hematologist immediately.

Time seemed to stop completely as I tried mentally to digest the situation. I stepped out of the truck attempting to regain my composure, and prepared to ask the dreaded question. Finally, I desperately asked, “Can we still do the surgery?” Dr. Reed replied, “No”.

Days of Despair
Engulfed in a tidal wave of emotions, I just stood in the middle of the parking lot sweltering in the hot Florida sun. I could not comprehend anything. Dr. Reed then explained to me how to find a qualified hematologist in the phonebook, and he instructed me to call him with the name of the hematologist. We ended our phone call, and the whole world seemed to end with it. SRS was canceled eight days prior to surgery. I just started crying.

Then somehow, as if there was a tiny light of hope in the distance, I remembered the little cliche on the therapist’s desk stating, “Determination is remembering what you want”. I slowly walked up the street to a nearby thrift store and asked the clerk if I could borrow her phonebook. I located a hematologist and managed to schedule an appointment for June 8th. I called Dr. Reed and gave him the name of the hematologist per his previous request. Dr. Reed stated he was going to perform a background check on the hematologist and further stated he would call me back in four hours.

I was a complete emotional wreck and was developing a headache that was reaching ballistic proportions. I was already late for work, and I knew there was no way I could make it through a work day. I had perfect attendance up to that point, but that was about to change. I located the human resource director, explained I was sick, and she gave me the rest of day off. I went home and went straight to bed. Later that afternoon, Dr. Reed called to inform me he had completed a background check on the hematologist. Dr. Reed stated the hematologist’s credentials looked good and advised me to follow through with the appointment. I was totally amazed that Dr. Reed would go to these great lengths to insure my welfare.

The morning of June 8, I received a call from the hematologist’s office. The receptionist abruptly stated unless they received my medical records immediately, they were going to cancel my appointment. There was no time to waste as this appointment was only a few hours away. I first attempted to contact my physician but only reached voicemail. In a panic I called Dr. Reed’s office. Dr. Reed answered, and I explained the situation. He said, “Let’s do a 3-way call right now”, and proceeded to contact the hematologist’s office. He spoke directly with the hematologist and made arrangements to proceed with the appointment. Just before we ended our call, I told Dr. Reed how much I appreciated him helping me. He simply stated, “It’s our job”. Nevertheless, I’ve never seen a doctor go to these extremes.

A New Beginning
The hematologist ran some tests, and strangely enough, my blood levels had increased slightly. The levels were still too low to perform surgery, however, and the hematologist ran several more tests before attempting to remedy the situation. We began discussing possible solutions, and I stressed avoiding testosterone at all costs. It seemed that Procrit was the ideal solution; however, Procrit could cost up to $2000.00 per injection, and several injections would be required. My insurance did not cover injectable medication; however, the lab technician stated that I might qualify for assistance through another program. She assured me she would do everything she could to get the medication approved.

The hematologist’s technician updated me daily as to her progress, and finally her diligent efforts paid off. I was approved for Procrit! I remain eternally grateful to this beautiful technician for her efforts in obtaining this medication. We began daily injections, and several days later the levels increased to the desirable range. The hematologist contacted Dr. Reed, and on June 29 Dr. Reed called me stating we were cleared to perform the surgery. Dr. Reed thoroughly reviewed all medical records and recommendations. A preliminary examination was scheduled for Tuesday, July 13, and SRS was scheduled for Thursday, July 15.

Vaginaplasty
We arrived in Miami mid afternoon July 12 and checked into the Bay Harbor Inn. What a beautiful setting for recovery–ocean air, coconut trees and the inter-coastal waterway at the front door! As I looked across the waterway, a boat party of naked women cruised by. Holy moly! No wonder Dr. Reed’s patients recover so well!

On Tuesday, July 13, we walked to the Reed Centre for the preliminary examination. Entering the Reed Centre is comparable to going from one dimension into another, like Alice in Wonderland. The waiting room is a gallery in itself. One should be charged admission just for entry to this room. It’s beauty is beyond comprehension. The design of the room is unique with it’s giant circular skylight and spherically mirrored reception area. The walls are beautifully decorated with Dr. Reed’s paintings, many of which are his renderings of priceless masterpieces.

Anne opened the door and stated, “Susan, come on back”. The back offices were also beautifully decorated with Dr. Reed’s artwork. I was intrigued by the architecture of the centre, especially the uniquely designed marble and glass domed corridor leading to the surgical suite. Dr. Reed’s paintings lined the entire length of the corridor. I could have spent the entire day indulging myself in these gorgeous paintings.

I was overjoyed to meet Anne after all our phone conversations. Anne is truly an amazing person. She has a wonderful sense of humor, and we instantly started cutting up and carrying on as she prepared my files. As we were conversing, she looked up and appeared to look behind me. I turned around to see Dr. Reed standing behind me in the glass marble corridor. I was instantly taken by his presence and his radiant smile. Finally I said, “Dr. Reed?” He warmly replied, “Hello Susan, follow me”. He led me down the corridor to the surgical suite where he introduced me to Vladimir and Uncle Bob. Uncle Bob was familiar with the area where I lived, and we reminisced for several minutes. Dr. Reed then led me to another room and began the preliminary examination. The exam went very well which was a huge relief. We discussed all the final details, and Dr. Reed administered one last injection of Procrit. SRS was “go” for Thursday.

The following day the bowel prep was started. Citrate of Magnesium is a “tasty” treat best served on the rocks in a glass with an umbrella, and enema’s are…. never mind. I’ll spare the sarcasm as I have no diplomatic method to describe this subject. Just remember it’s for a good cause.

Thursday, July 15, began with a “wake up enema” at 5:00 AM. After recovering from the enema, there were no words to describe the anticipation. I kept thinking, “Suzie’s not scared”, and I really wasn’t scared either. The long awaited day was finally here. At 7:15 AM we walked to the Reed Center and I once again gazed at the paintings while we waited. Anne opened the door and said, “Susan, come on back”. She handed me a gown and led me down the corridor to a small room with a bathroom. She showed me the lockers for my belongings and instructed me to use the bathroom one last time. I put on the gown, entered the surgical suite and climbed onto the operating table.

The room seemed full of abstract activity as Anne and Uncle Bob made all the necessary preparations for surgery. Nobody said a word, and I just laid there staring at the big circular light aimed at the table. Then I noticed the light seemed to be getting larger. I looked away and noticed the walls were rippling as if they were under water. Realizing the anesthesia was taking effect, I looked up at Uncle Bob and thought, “Night nite”.

I heard voices and began to see shapes moving in the cloudy white light. I recognized my mothers voice and could see her image beginning to appear. The surgery was complete, yet there was no gap in time. My brain was attempting to reinitialize but only uploaded a half sedated personality. My first words were, “Was the surgery successful?” My mother answered, “Everything went just fine.” The pressure from the vaginal packing created the illusion that I had to go to the bathroom really bad. I then assumed the role of Little Miss Blabbermouth: “I gotta pee. Where’s my phone? Call Linda. Call my father. I gotta PEE!” A pulse monitoring device was clipped to my forefinger, and I could hear the sound of my pulse beeping next to me. When I started moving around, the monitoring device sprung off my finger, and my pulse went to a steady tone. “Beep, beep….. beeeeeeeeeeeeeeeeeeee.” I exclaimed, “Am I dead ?!” Needless to say, I think Dr. Reed was much happier when I finally settled into a more restful state.

The side effects of the anesthesia began taking it’s toll, and I became considerably nauseated as the evening progressed. Rose kept close watch over me throughout the long night, and she tended to my every need. She was only weeks away from completing her doctorate, and she managed to get some studying in during my more restful times. When I was awake we talked about everything and anything. I will always have fond memories of Rose, and hopefully our paths will meet again someday.

Dr. Reed checked on me at sunrise and offered me breakfast. Unfortunately, I had to pass on breakfast because I was still nauseated and could not keep anything down. Dr. Reed said nausea sometimes happens with small women and this would go away eventually. Shortly thereafter, Anne arrived and tended to me throughout the morning. At noon Vladimir helped me into the wheelchair, and we proceeded back to the Bay Harbor Inn. The nausea still remained which took my mind off the bumpy wheelchair ride. I can still hear Vladimir’s gentle voice saying, “Susan, you have to try to eat. You need protein to heal. No protein, no heal.” Later that evening I was finally able to eat a saltine cracker and some Jell-O.

The following morning Dr. Reed came to the hotel room and checked my bandages. Except for my headache, everything looked really good. Dr. Reed suggested coffee for the headache which worked like a charm. Later on I was able to hold down some breakfast. I began regaining my strength throughout the day and even managed to venture outside for a few minutes. Each day I continued to improve, and Dr. Reed visited me every day at sunrise. One lesson was well learned, however; if you have long hair it’s best to braid it just before surgery. Being on your back in bed for several days creates a knot the size of a bird’s nest which is literally impossible to remove.

Exactly one week after the surgery, I was able to walk to the Reed Centre to have the suture removed. The suture removal was the most painful part of the entire experience, and I was quite relieved when this procedure was complete. Afterwards, Dr. Reed explained dilation techniques, and we thoroughly reviewed all post-op care procedures. He seemed quite happy with the results, and we briefly discussed the labiaplasty that was to be scheduled in three months. Everybody exchanged hugs, and I was on my way home that same day. I could hardly believe this major milestone was rapidly becoming part of the past.