Five.

I did everything I could to avoid thinking about the hospital after my lung collapse. The hospital became just another monotonous institution. The drip. The sterile stench. The loss of time. The clinical bedside chitchat. The brutality. Instead, once discharged, I went to raves. There is no place for the meek in a rave. You have to move, to feel both in and out of your body under the blue light, to pretend there is a new world revolution coming, even if there is most certainly not.

Six.

When I woke up a few hours later, drenched in pain, my partner, D, was the first person to walk in the room. Later they would tell me that I looked like I’d been a domestic violence victim: My face was battered and bruised, my eyes swollen shut. It was hard to breathe. I tried to talk but struggled, wincing at D to read to me.

Seven.

I recall my surgeries through the books I read before surgery and during recovery. The book I had brought to speed read while nervously waiting to go under before FFS was Ursula K. Le Guin’s The Left Hand of Darkness. D struggled and laughed over the nonsensical words and proper nouns: “kemmer,” “Genly Ai,” “Gethen,” “Estraven.” After a few pages, I fell asleep. Or something resembling it anyway. Real rest would allude me until the pain subsided. I struggled to eat or keep anything down—could not even focus on the Nintendo Switch I’d bought for when reading became too arduous. All things in time. Some have a remarkably easier time getting back up and around. But I took the pain to heart. I needed people more than ever before. Becoming dependent on others was hardly my default. I always needed friends, sure, but this was different; this was bodily care. I required help getting up and down, showering, removing dissolving stitches that got stuck in my skin, preparing food.

Somehow, smoothie after smoothie, after sleepless nights and mind-numbing Golden Girls marathons, I regained my strength. It wore thin. After the three weeks of friends visiting wore off, I broke down crying, the drugs flushing from my body as I came down.

Then, of course, there’s still a few more weeks to go before something like normal is even in reach.

Eight.

Plastic surgery’s omnipotence has become highly contentious. Jia Tolentino decried the encroachment of “Instagram Face,” or the atomizing desire for women to shape their once unique faces into the same “distinctly white but ambiguously ethnic” visages in a viral piece back in 2019. “In a world where women are rewarded for youth and beauty in a way that they are rewarded for nothing else,” she writes, “and where a strain of mainstream feminism teaches women that self-objectification is progressive, because it’s profitable—cosmetic work might seem like one of the few guaranteed high-yield projects that a woman could undertake.”

The Atlantic’s Sophie Gilbert has used a different perspective to make a similar anti-surgery conclusion, arguing against surgery optimization, influenced in part by the rise of AI and Photoshop capable of digitally constructing a “perfect” face. An abundance of plastic surgery is not a net good: The endless pursuit of beauty is fueled by patriarchy, whiteness, and wealth. But discussions over its morality often hinge on blaming women for desire instead of seeing it as a jumping off point for self-determination.

Is plastic surgery an act of bodily determination or a capitulation to patriarchy? Feminist perspective is often divided on this question. In 2023, critic Philippa Snow attempted to outline the divide: “I believe that giving a nineteen-year-old girl a whole new face is, frankly, not exactly ethical, but I also believe in few things with more certainty than a nineteen-year-old girl’s right to bodily autonomy. There is no easy way to reconcile the two ideas, making it lucky that I also believe feminists can contradict themselves.”

Rarely are trans women considered in this discourse. We are either considered an outlier not worth parsing, or the exception that proves the rule. Our bodies are not included in the count, perhaps because they’re seen as alien rather than mundane. When trans women are included, it is primarily by trans exclusionary radical feminists who decry trans surgery as a form of mutilation, a false mimicry, an unnatural abomination, a vain cyborg freakshow. TERFs like Mary Daly were known for their appeals to a more earthy, Mother Gaia–type feminism. They advocate for a more minimalist purity.

Nine.

My face is political. Some nuance is required. While many cis women wonder if we’re becoming too permissive of plastic surgery, many trans women are losing their health insurance at an alarming rate. Is desire a trap? Or can it perhaps guarantee some safety from strangers on the street? Beauty is a two-way mirror: You don’t see me, I don’t see you, and neither of us exits an encounter feeling better about ourselves. But for some of us, it is a currency and we need some more capital in a world that wants us dead.

Ten.

I don’t get to take the bandages off for a few days after vaginoplasty, which is fine, because those first few days were a haze of intense pain and trying to stay on top of my med schedule. Some nurses were more forgetful than others. I am in the hospital far longer than I was for facial feminization surgery. D came most days and stayed overnight when they could. Other days friends came and brought flowers. Very Georgia O’Keeffe.

When the dressing was finally removed, I was taught how to dilate. Four times a day for 15 minutes each. The canal had to be stretched. It was not as sexy as I’m making it sound. The chipper, gay discharging nurse taught me the basics: I lay down on a padded slab and elevate my legs with a roller. It’s somehow both more and less painful than I imagined. I don’t scream so much as wince loudly as D stands off to the side, holding my hand. More than anything, it’s uncomfortable. While the nurse makes jokes about bottoming, I smile and nod, trying to maintain small talk as he helps maneuver the first of the four dilators inside me.

On the car ride home from the hospital, I sit in a padded car seat to avoid applying pressure to my new groin. I do not relate to the women who say they felt an instant sense of relief when they looked down at their new lack. My lack does not instantly make me happy, as Andrea Long Chu once said. I do not think of surgery as a vending machine for joy but as a means to an end. Another thing on my to-do list.

Eleven.

After vaginoplasty, I do feel something akin to gratitude. Not to the doctors, who were merely doing their job, but to myself. I had outlasted something. I could breathe. It was not a cure-all; I was not broken and suddenly fixed. I was merely more open to the world.

Vaginoplasty is immobilizing, requiring a lot of rest and daily dilation even after leaving the hospital. Four times a day for the first few months. “Morning glories— / just when I tired of waiting / blooming at noon,” the great haiku poet Issa wrote in 1811.

Twelve.

The first few days I felt bogged down in my own personal sea of slop. There was blood and discharge everywhere. Lots of it. I put down puppy pads and pour a criminal amount of Surg-i-lube onto my body. I am on far too many pain meds to ever imagine this being sexy. When I run out of refills and am still moaning while downing CBD edibles, my trans mother sends me Vicodin in a little pink plastic heart box alongside a little snow leopard plushie.

Thirteen.

Surgery requires such communal openings—the gathering of a care team, emotional support., the vaginal canal that needs daily dilation. The first few weeks require progressively sizing up dilators in order to maintain depth and width. Of course, the small dildo-looking medical devices are color-coded and vulnerable to the scrutiny of airport security. In order of size: purple, blue, green, and orange.

Fourteen.

My trans friends use a variety of nicknames for the surgery. The Chop, The Operation, The Big One. I enjoy “sex change” for its lack of ambiguity. Sometimes, however, we just call it The Surgery.

Fifteen.

A few weeks into recovery after vaginoplasty, when I’m still struggling to get the rigid purple dilator in my new box, I posted a photo of a Judy Chicago painting. My friend who has also undergone vaginoplasty messaged me. “Isn’t it crazy,” she writes, “to understand Second Wave Feminist Art now?” I laugh. “You see how they’re actually good now.”

Second Wave Feminist art felt so abstract to me before surgery. When I was just starting to transition I read Intercourse, by Andrea Dworkin, and Gyn/ecology, by Mary Daly. I devoured the texts of my enemy, or those whom I thought might be reparable for my own gender-making project. I found myself much more ambivalent than I expected. Less outraged. Their language was rich; their racism was notable; their ideas about wombs and womanhood were fascinating. These feminists wrote off trans women as merely envious of the life cis women enjoyed, and therefore, envied trans women in turn for our perceived freedom. Yes, I thought, reading Dworkin on Tolstoy, this rage of men is the point. I have never felt it. I do not think of murdering my wife; I think of murdering myself, the masculinity that I want to split off from myself.

Sixteen.

Dilation requires splitting the conscious self from the unconscious. The mess must be coming from a different person—the lube and discharge and blood. All of it. But I know better than to write a vagina monologue. Pornography, Dworkin asserts, is a word with roots in “graph,” Latin for writing. A new body part requires time to heal and become a part of the whole. At first it is a foreign object—one that must become good through wholeness. I am trying to write my vagina into connecting with the rest of my body. Through words, I will sew it on. A lexicon of surgical procedures.

Seventeen.

One day I take a look in the freezer and discover a box of Uncrustables.

“Where’d these come from?” I ask D.

“You literally begged for them. It was all you would eat,” they say. “You guided me to where they are in the grocery store.”

“I don’t remember that,” I say. “I don’t even know where they are in the grocery store.”

The pain, D says, must have distorted my ability to sort and store memories. I am telling a story to make sense of the facts, to sew myself back up.

Eighteen.

Whenever someone asks what to expect after surgery, I try to warn them of “the drop.” A few weeks after nearly every surgery I’ve had, whether gender-related or not, I fall into a deep sense of despair after the anesthetic has left me barren. The depression swarms my body, a chemical hijacking I cannot escape. The first time it happened, I was surprised. I nearly fell on the floor. I called my friend crying and she came over to sit with me on the floor.

When it snuck up on me after vaginoplasty, I was prepared. I made sure my care team extended past the point I thought I would need someone to physically be with me and help me shower or walk. My boyfriend’s best friend came over and we watched a movie by Hong Sang-Soo with Isabelle Huppert, a favorite of ours. Of course, I don’t recall a single scene even though I rated it online.

Nineteen.

After a few months of moving through motions and dilating four times a day, I feel like I have become a vagina. It erodes my ability to do anything else with my days. Like Philip Roth’s Kepesh in The Breast, I have become a mass of my own desire. The main character, a professor obsessed with his girlfriend’s breasts soon becomes one. This is the opposite of Mary Daly’s transsexual fear, she who can only see that “these men have no penises, but their whole body, their whole mind is still a penis. Their eyes are penises, their hands are penises.”

Like the trans panic craze over literature turning everyone gay, Kepesh wonders if fiction did this to him. “No,” his analyst replies. “Hormones are hormones and art is art.”

Twenty.

“May a transsexual hear a bird?” Harry Josephine Giles writes in a powerful poem of the same name. “When I, a transsexual, hear a bird, I am a transsexual hearing a bird; when you hear a bird you are a person hearing a bird. That is, I am specific, you are general.”

Twenty-One.

Perhaps, in a roundabout way, noted TERF Janice Raymond was right about something: “Physical pain is a constant reminder to transsexuals that they are finally coming alive.” As Kay Gabriel writes in “Gender as Accumulation Strategy,” we need a “transsexual hedonism.” Perhaps such hedonism can include masochism, flipping the nightmare Raymond talks about in favor of pain as a tool rather than as a weapon. As such, masochism is not a modality of validity, but a verb—a process.

Trans surgery—alongside some other forms of plastic surgery—is not just about bodily autonomy. It is a material issue just like class or healthcare.

Twenty-Two.

Roland Barthes offers a reparative reading on materiality: “Plastic is the very idea of its infinite transformation…. it is this, in fact, which makes it a miraculous substance: a miracle is always a sudden transformation of nature.” In Mythologies, he speaks of plastic as “the transmutation of matter,” it “has climbed down, it is a household material. It is the first magical substance which consents to be prosaic.” Plastic was once reserved for the bourgeoisie, but now has become part of the mundane, a material for the people. For some surgery is not just a matter of beauty but labor.

Twenty-Three.

After only two visits, my physical therapist tells me I’ve picked up kegels quickly and no longer have to take an expensive cab into the city to see her. (You’re not supposed to apply too much pressure to your groin post-surgery and subway stairs are the worst agitators.) I cancel the rest of our appointments and decide to enjoy the rest from pay-what-you-can yoga and taking long walks around Brooklyn. For a few months I stay indoors and watch too much bad TV, waiting for my strength to return.

I don’t, however, stop working. I interview a famous author while stoned on painkillers.

“That’s so great you get to be yourself,” they tell me.

I nod enthusiastically, ready to move on and ask my first question. I do not get to be a woman without an asterisk on or off the job.

Twenty-Four.

A year or so after surgery, when I read To Rest Our Hearts and Minds, a moving novel by Harriet Armstrong, I’m amazed when reading a description of a cis woman learning how to dilate. Of course, cis women get vaginoplasty too. Whether because they’re too tight or they desire a rejuvenation or because of muscular atrophy. Still, it’s a reminder. Bodies are fungible; not just trans people go under the knife or take hormones. Yet they feel a world apart in how they’re legislated.

Twenty-Five.

A man who is interviewing me about my book asks me if I have a G spot. I answer him. Later I wish I hadn’t. My sex life is an inside joke that no one will explain to me. Perhaps because what I have undergone is considered so socially fraught it seems like everyone else’s business rather than merely my own private affair. Of course, at times, like when writing this, I make it public, though on my own terms. But it feels like people already have a priori turned my vagina into a highly circulated debatable affair. My womanhood is a public forum for amateur men to stake their own claim on defending traditional gender roles. Anytime I write, a sea of faceless avatars decide to pick apart my face, my body, my life. Of course a man asks if I have a G spot. He’s just asking a question.

Twenty-Six.

My dilation schedule is reduced to three times a day. After six months I moved down to twice a day and after a year I was finally allowed to only dilate once a day. It’s a grueling schedule. You’re tied to the bed—and the home—for months. Even now, I’m supposed to be dilating at least once every other day. Which means that when I travel I have to bring my dilators through airport security. The alarm goes off every time. Apparently they look like weapons. They should see the sharp silver instruments my gynecologist carts out during check-ups.

The last time I traveled, TSA took out the orange dilator from its careful wrapping, uttered “Oh!” and threw it back into my purse, unwrapped. I imagine she thought it was a dildo. Close enough.

Twenty-Seven.

I have always imagined I would keep quiet about The Big One. My flaw, my shame. My vagina, myself. But I keep picking at the scab, the sheath bleeding as I keep having to get pesky granulation tissue treated. I worry it isn’t polite to write about, something I’ve rarely thought about when reporting or discussing the many grim topics I’ve covered. This is not how I want people to imagine me: splayed out on the operating table, receptive and helpless like the masochism of Yoko Ono’s Cut Piece. But the hospital has become my routine. I can’t say I’m at peace when I go to the hospital for these check-ups. But I am comforted by the routine, and the knowledge that I am just one in a line of women going to the gynecologist. My doctor tells me I have immaculate depth and I smile.