(C) 2020, By Fran Fried
April 27, 2010, a cloudy late Tuesday afternoon, just before 5. A clinic in Selma, California, a small, dusty, raisin-farming community in the San Joaquin Valley, 20 minutes south of Fresno. The clinic, affiliated with the hospital next door, had a clientele that mostly consisted of working-class and lower-income Mexican families … and, occasionally, women in varying stages of gender transitioning, there to see the post-op transwoman doctor; since so many of her patients were financially struggling and/or out of work and without insurance, she charged them on an affordable sliding circle.
In my case, on this day, I was seeing Dr. B to change my life.
I’d been leading up to this Rubicon crossing in steps – well, I guess from childhood, but concertedly for two years, since the January night when I unexpectedly confronted myself, had my epiphany, simply asked myself “Can you do this?,” and realized, after four decades, I just couldn’t suppress this part of whom I was anymore. The night I finally surrendered and said, “Okay, this is where I’m going – how the hell am I gonna do this?”
And after a series of many tentative baby steps and occasionally huge strides – and after unexpected moments of joy, and moments of pain both expected and unexpected – here I was.
But not until after going through a series of mental speed bumps. Every so often, in the two years leading to this moment, I would occasionally ask myself, “Is this really where you’re going?” That question was compounded by 13 months (of an eventual 2 1/2 years) of unemployment, as I had been discarded in March 2009 by The Fresno Bee – the assistant features editor job for which I packed up my life and moved cross-country from New Haven five years before – in McClatchy’s first round of newsroom layoffs. I had to consider whether I’d interview for my next job as Fran or as Fran. The search for work prodded me along in the process.
I actually welcomed these occasional self-intrusions, because the effects of the hormone replacement therapy would be irreversible. And each time, I responded with “Can you really see yourself living as a man?” And each time, I would knowingly smile a tiny smile. I knew; it was just that the permanence scared me a little. But not living as my actual self, or much closer to it, scared me a lot more.
In a chain of happy accidents, I found the only gender therapist in Fresno at the time, and I started seeing her that September. In November, two months later, after a 500-plus-question test administered by a professional from SoCal, she cleared me psychologically for HRT. (This was just before WPATH, the World Professional Association for Transgender Health, eased its
Standards of Care protocol for patients seeking hormones, going from requiring clearance by a therapist to strongly suggesting it.) And after that, she told me of the two doctors in the million-person Fresno County at the time who prescribed estrogen. One was a man in Fresno who prescribed it in pill form; the other was the transwoman in Selma who used injections, which were more effective. I mean, for me, this was a no-brainer. And what’s a short ride down the 99 freeway, anyway? Besides, it got me out of town for at least a little while.
This would be no free pass, though. On my first visit, in March, Dr. B actually declined to start me on the hormones; she was concerned about my weight, a huge problem since my late 20s (I was 48), as well as my cholesterol levels (high numbers for the bad stuff, low numbers for the good stuff), because the side effects included weight gain around my midsection and the increased chance of a stroke. She was not a warm and fuzzy person; she could be brusque, a hardass, but ultimately I came to realize that she did empathize, having been through the drill, and she had my back. But she also emphasized, by her manner, that this transition would be a tough road ahead. (I knew that already, actually; at that point, I had been out full-time about a year, and was halfway through a 14-month bout of weirdness with my family back in Connecticut since coming out, and out of a job for 13 months and living off unemployment.)
Anyway, she put me on a cholesterol med just to make sure it wouldn’t damage my liver, set me up with a clinic dietitian, and had me return for this visit, and part of me expected this wouldn’t be the day I’d start, either. I was brought into the office by one of the staffers, made to step on the large scale I imagined one would use for certain livestock, then waited semi-anxiously for the doctor for about 20 minutes under the bleak fluorescent lights of the room. In she walked – curly blonde hair, a shade taller than me, yellow dress with red print pattern. She said she was pleased with my results, and she gave me the okay. She would see me again in two weeks; wait for the assistant to come in and administer the shot. I would now have to take the shots every two weeks for the rest of my life, she told me.
And a few minutes later, the assistant came in and prepared the shot of estradiol valerate, the synthetic estrogen that would be used. I pulled down my leggings far enough; she soaked a cotton ball with alcohol, rubbed a spot in the Bermuda Triangle between my right hip and cheek, and drew from the tiny glass vial. And in went the needle before I had the chance to think about it. It was a pinch, but a sharp, painful one, and I was bleeding like the clichéd stuck pig.
“Wow – you’ve really got a big butt,” she said as she applied a Band-Aid. I told her it was from a combination of doing a lot of bike riding these days, and just naturally having a girl’s booty from childhood; I explained that in my skinny teen years, I was an ass on a stick.
But that’s it, is it? Is that all there is, my friend? Yep – a big pain in the ass, but not as big as getting there. And I was now in the club. No going back.
And now, suddenly, it’s 10 years on. And here’s what’s come of it …
Tags: estradiol valerate, Fran Fried, Franorama World, gender identity, gender transition, hormones
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