By Greyson Lorio.

For a long time I didn’t think that I needed gender affirming healthcare. I didn’t really think about my body that much. I got along just fine day to day. Things were fine. But that was the problem, things were just fine. 

I had struggled with self-esteem and body image for years. At the time, I thought these feelings were regular manifestations of low-self esteem and insecurity that everyone dealt with. Everyone feels a constant nagging sensation that they are showing up “wrong” right? (No) Especially for people affected by misogyny, these feelings are just a product of sexism! (Not entirely) I should just practice body neutrality and accept my body exactly as it is. That seems to be the “right” thing to do. (Again, not entirely). 

Part of this was because I was not drawn to HRT. As a nonbinary person, I didn’t want to be a man, but I knew I wasn’t a woman either. Thinking about the changes that my body would go through on testosterone did not quite get at what I was unhappy with. Consequently, since I didn’t see HRT in my future, I didn’t even consider surgery as an option. In my mind, I had constructed a staircase of gender affirming care. First, you socially transition, then you go on hormones, then you get surgery. Since I was not climbing the staircase in the “right” way, I had taken all of the options off the table.

Now, to be fair to myself, historically, this order of events was the only way to access gender affirming surgery. That history combined with conservative talking points that someone must be absolutely, positively, 100% sure that they are trans before they irrevocably alter their body swirled around in my mind. 

Two things happened that shifted my perspective. They both boil down to someone saying, “It doesn’t have to be this way. You can choose something different for yourself if it would make you happier”. 

In early 2023 I received a phone call for a survey about my healthcare experiences in North East Ohio. One of the questions was, “If you could use any method of birth control what would it be?” and the caller listed the options they had in front of them: the pill, an IUD, condoms, a hysterectomy. That last one caught my attention. I had never been presented with the prospect of a hysterectomy as a birth control measure as equally valid as the pill or an IUD. I realized then, that if I could use any method of birth control, I would choose a hysterectomy. I knew that I never wanted to be pregnant. I knew that bleeding every month was a chore and half to deal with, on top of being unnecessary because I never wanted to be pregnant. Suddenly, knowing that I wanted this surgery became reason enough to get it. 

The second experience happened at the Trans Ohio Symposium in September 2023. I attended a panel on trans-masculine surgery experiences and one of the panelists said that you don’t have to just feel fine in your body, you can love your body and surgery can help get you there. Hearing somebody else say that you don’t have to feel “just fine” made me look at my experience in a different way. I had been wearing a binder for a few months and loved it. I realized that I did not want to have breasts. Furthermore, I could want to not have breasts and also not want to be on HRT. So now I knew that surgery was something that I wanted to do, the next step was to do it. 

I consider myself very lucky to have been able to work with two surgeons who made the surgery process very easy for me. Dr. Maria Shaker at UH used the informed consent approach and performed my hysterectomy. Dr. Chepla at Metro did my top surgery and did not require any additional documentation other than the letter from a therapist required by my insurance. He did not question why I was not on HRT and was very easy to work with to get the results I wanted (no nipples and no drains). I also had insurance through my work that made both surgeries affordable for me. I recognize the immense privilege in that. 

Now being a year out from my hysterectomy and over 6 months out from top surgery, I can truly say that I love my body and mean it. I feel like a weight has been lifted (lol). I can more comfortably move around the world and interact with other people because I don’t have this ever-present sense of self-consciousness gnawing at the back of my mind. It seems ridiculous now, but I really thought that feeling was normal and just something I had to deal with. 

I had already been identifying as non-binary for a few years, but because I was not experiencing the same dysphoria that I knew other people who received gender affirming care experienced, I didn’t think my experience was “bad enough” or that I was “trans enough” to deserve gender affirming care. That line of thinking is a gender essentialist and trans-medicalist trap that would have kept me from living as my authentic self for my entire life. The truth is that neither I nor you have to do or be anything to deserve gender affirming care. That misses the point entirely really. Instead of asking myself if I deserved gender affirming care, the question I came to ask myself was, “What do you want?”