Friday, May 24, 2013

Life Happened...

Hey ya'll -

I am so sorry it's taken me so long to get back in front of the computer! It was October when I last wrote an entry and just so you know I haven't been twiddlin' my thumbs lately, I'll just list the number of BIG things that have happened since then -

*Rey was published in the first ever anthology of transgender short fiction!
*I applied for and was offered a job at Portland State University in Oregon - and I accepted it!
*Rey had his top surgery October 26th
*Rey started taking testosterone November 8th
*We moved ourselves and our two cat children to Portland via a cross-country roadtrip that beat all at the beginning of December (we had to give our turtle to someone else because we didn't think he'd make that long trip)
*I transitioned into my new job, working a satisfying but long 10-11 hours/day for the first few months
*We moved again at the beginning of May to our more permanent home here in Portland after having spent six months at a temporary apartment complex.

I'm sure I'm missing stuff but seriously - that's one jam packed 8 months, wouldn't you say? I really can't even believe all that happened at the same time!

Anyway so I've got some catchin up to do! Let's see how well I can do that for you in a timely manner. :)



Sunday, October 21, 2012

Wake Up Call

As you may have been able to discern from the title, this is going to be less of an uplifting entry as compared with the others and before I get into it, I wanted to just step back and let you in on an exciting change you may have noticed. My partner, Rae, now goes by Rey. This is something I just began writing as I was updating the blog recently and I realized I never pointed it out or explained. In addition to going by "Rey" and "Reymond" in his personal life now, he has also petitioned for his name to be officially changed with the city so he can get a drivers license that matches his identity and as soon as that goes through (any day now), he'll be able to officially change it. Woo Hoo! So look to read more about Rey soon and know that I haven't broken up with the love of my life and begun dating someone of a very similar sounding name who also is trans and wants to preserve his fertility before starting T...it's the same old Rey! lol

With that said, here's your next edition of the Transgender Baby Steps Blog!

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For people living in poverty and for people in the middle class alike, preserving fertility may seem like an unrealistic goal. After all, having a baby is expensive enough on its own - undergoing medications, examinations, treatments, and surgical procedures just simply to save up the little guys for later can cost anywhere from $9,000-13,000 and that just might seem excessive and fiscally irresponsible.

But after you start digging around for the information (and with the help of some knowledgeable health care professionals), you can find options for doing what needs to be done at a cost that is anywhere from nearly affordable to absolutely FREE.

Here are some ways we found that would provide a person with alternative financing options for this type of procedure. There are probably more so make sure you look into it!:

-Insurance Coverage - OK, this didn't work for us but it does work for some so check with your provider to see. However, one word of warning (passed along to you from someone in the biz) is that they only need to know what they need to know. This means that you should not offer up any information unless they ask you - you don't want to be disqualified because their company belief is that it isn't "essential" for you to do this because you're queer, trans, single, etc. Just tell them what they need to know.

-Other Clinic-Provided Discounts - Our fertility clinic was able to give discounts to people working for larger companies and organizations in the area who, although they had insurance, would not receive any coverage for the procedures.

-Research Studies - Participating in research studies may make you eligible for discounted or free medication and other procedures. Find out from your fertility clinic what programs they know of that are happening in your area.

-Compassionate Care Program - The pharmaceutical company making the medication most individuals take during this procedure (Gonal-F) gives the medication for FREE to those who meet their financial need criteria - Saving you around $9000 if you qualify.

-Donating your eggs to the clinic in a separate cycle - This may not be something you're comfortable with - the idea of your brethren being born to and raised by someone else entirely and potentially never getting to meet them (at this time, most legit egg donation clinics require donors be completely anonymous) However, if you think you can do it mentally and physically (there are also health-related criteria you must meet for donating), you will see sweet rewards up to $8,000-10,000 in the United States. Also, keep in mind that some clinics will not allow you to donate of you're only doing it to offset the cost of your own procedure as they don't want the reason for your donation to be wrapped up in the rewards themselves.

Of course, if you read the last entry, you know what happened when we tried to get insurance coverage. We also tried to get in on the research studies but there were none going on that we would have been eligible for at the time. So we set out to take advantage of the Compassionate Care program.

Rey filed all the necessary paperwork and sent along his proof of income. He received a call back within days - much faster than either of us had imagined. After asking questions to verify that he was the one who had turned in the paperwork, the woman on the other end of the phone asked if he would be the one carrying the child. In response to the question, he said, "I need to disclose to you the situation of why I am pursuing fertility treatments just to be clear so you are not confused. I am technically in a same sex relationship with a woman, but I am going to be transitioning to male. I identify actually as a transgender individual. My partner and I – we’ve been together five years and are engaged – are freezing my eggs because once I begin using testosterone as hormone replacement therapy, my ovaries will no longer be able to reproduce. So I will not be the one carrying the child, my partner will later carry the child through invitro."

The woman paused for a long time and finally said, “This program is not for you.”

At this point there was no further explanation of why, only silence on the line. Rey eventually said, “Ok…?” The woman finally explained that it is not their practice to provide free medication for someone who is going to be freezing their eggs for future use. The program is only for couples with infertility issues trying conceive now, UNLESS a woman has cancer or some other catastrophic medical event in which it would be considered medically necessary to preserve her fertility. While we of course knew that this procedure was medically necessary for us, we realized now that we had to prove it.

In the meantime, we had already been considering donating eggs as a way to compensate for the cost of our own procedure. After getting this news, we were more sure that this might be our last remaining option. At this point, we'd been knee-deep in the process for more than six months but without some way to help pay for the procedure, we weren't sure we'd be able to do it. I was nervous that we'd become attached to the idea that would never come to fruition.

We had already been on our fertility clinic's website for egg donation and Rey met all of the criteria. That, along with the fact that they had been amazingly supportive, understanding, and incredibly trans and queer-friendly all made us feel pretty confident that this would be as simple as just letting them know we were interested in donating. Here's the criteria they list:

Are you between the ages of 21 and 32 years of age?
Are you in good health and a nonsmoker?
Do you have regular menstrual cycles?
Do you have both ovaries and do you have no reproductive problems?
Do you have no current history of a sexually transmitted disease such as chlamydia or GC?
Do you have no history of HIV or hepatitis?
Are you psychologically healthy?
Do you have no current use of drugs or excessive alcohol consumption?
Do you have no family history of inherited genetic disorders or conditions?
Does your work or school schedule allow you to make it to daily doctor’ s appointments?
Are you willing to take hormone injections?
Do you have a car, a valid driver’s license, or reliable transportation?
If you have children, do you have a babysitter for when you have doctor’s appointments?
Do you have a normal height-to-weight ratio? Is your body mass index (BMI<27).  You can visit www.nhlbisupport.com/bmi/ to see if your BMI is less than 27.
Are you dependable, mature, and able to keep appointments?

The website also clarified that donors get paid immediately after having donated, regardless of how quickly their eggs are used by other individuals. So, excited and nervous, Rey picked up the phone and dialed their number. I sat right next to him for support. He was immediately put on the line with the director of egg donation, herself. The following are nearly perfect quotes from the conversation:

Rey: "Hello. My name is Rey Drew. I'm actually working with Main Line already. I'm preserving my fertility before I transition from female to male and I am interested in donating my own eggs to offset the cost of my procedure."

Egg Donation Director: "Um, so you're having a sex change operation?"


Rey: "Well, not exactly <Welcome to 2012 in America, lady>. I will be going on testosterone to produce secondary sex characteristics and before doing that and potentially destroying my ability to reproduce, we decided to go through this procedure to preserve my fertility. I'm thinking of donating in a separate cycle".

Egg Donation Director: "<LONG PAUSE> Oh. Well, that's a very unique situation and everyone wants something more ...normal. I would have to tell people about this and ...well, no one is going to want your eggs."

Swear.To.God.

That was essentially the entire conversation which was then followed up by our collective cussing and yelling and crying that went on for a good, long while as we realized we'd been discriminated against by the same clinic that had made us feel so loved. I felt so angry that our trusted health professionals who seemed to know so much about appropriate trans and queer vocabulary and etiquette really hadn't been schooled on the more complex array of transphobic issues they were apparently perpetuating.

This used up the very last of Rey's motivation. He had no desire to call and speak with her supervisor, much less start an effort to fight back! I, on the other hand, felt internally obligated to fight back! When I see the line clearly drawn between right and wrong, I just can't help myself!

I called Main Line the next day during my lunch hour at work. A gentle, truly caring nurse we'd recently spoken with answered the phone and I relayed to her what had occurred the day before with the director of egg donations. I also told her we'd been denied the Compassionate Care coverage because of their philosophy that starting testosterone is a choice and not medically necessary. She seemed genuinely apologetic and said she would pass the message on to our doctor. She said she was certain that we'd hear back something from him soon.

It was a week and a half and three phone calls to him later when I finally heard back from Dr. Glassner one morning at 7am as I was getting ready to go to work. He didn't seem like the same charming, gracious soul we met on our first visit. He said hello and quickly jumped into the mini-investigation he had launched after receiving the message the kind nurse jotted down. He had spoken with the director of egg donations and she had confirmed that what we claimed was truth but she stood by her statement that "no one would want (Rey's) eggs". This, apparently, was very important to them even though they always pay their donors immediately after donating, regardless of whether they'd be purchased.

I waited for him to let me know he had reprimanded her or that she'd even been fired for practicing against their open, welcoming, diverse philosophy of practice. But he didn't say those things. He stood by her decision, saying she was the expert in that particular field. I argued with him that this was discrimination and if Rey met the criteria posted online, then he should be able to donate. And, I protested further that by keeping trans and/or queer people from donating eggs, they were preventing trans and queer people from having the option to use eggs from people similar to themselves.

I was livid! How was it possible that we fell for this? How was it that we had been treated like gold by all of our friends and all of our family members throughout Rey's coming out about being trans AND  throughout this fertility process, and these people - who didn't even truly know us - were judging us based on their assumptions and on society's real fear and hatred of trans people. What if Rey had disclosed he was a Muslim? Or what if Rey disclosed he had had a car accident in which he acquired a brain injury or quadriplegia? Then what? Would anyone want his eggs then?

Dr. Glassner became a bit more empathetic after I shared this viewpoint with him. He then apologized that i was feeling the way i was (which of course really doesn't mean he's sorry at all) and closed out our conversation with a deal. Yes, a deal. He was going to give us $4,000 off our procedure since we were not able to donate. $4,000, remember, is maybe half of what we would have gotten if we had donated. I told him I had to think about it and talk it over with Rey since this was not what we had hoped he would say. This was generous, yes, but it was a response to a heinously discriminatory experience we'd had by one of his staff...and that was going to cost us around $4,000-6,000 in the end...close to the exact amount we needed to completely pay for our procedure.


Monday, September 17, 2012

In Search Of (ISO)...




Thank you all for your patience! We've been having a great time on our journey and I'd love to tell you what has happened but that would be the spoiler of all spoilers so...I cannot. Until then, your next installment of the Baby Steps blog awaits you...



ISO Insurance Coverage!

I think I knew what was going to happen when I called my insurance company...maybe I was just wishful thinking. I knew that some people had insurance that covered these procedures for fertility but I was doubtful that my company was that great. It wasn't just the company - it was also my plan that was causing me doubt. Since I rarely needed to go to the doctor, I had the lesser of the three coverage options and Rey wasn't even on my insurance and, of course, he didn't have his own at the time. However, my thought was that if we found it to be cost effective, we could switch to a higher coverage plan and get him on my insurance. However, of course that meant higher monthly payments due to adding Rey to my plan, not to mention what extra we would need to cough up if we had to go with a higher coverage plan. Considering all this, I was imagining a $200-$250 per month increase in coverage. So I wasn't really convinced that going this route would actually save us money in the end, even if they did cover these procedures, but I had to give it a shot anyway.

Our clinic had given us a sheet of procedures we'd be having done with their associated medical codes so that we could contact our insurance company to find out if anything could be covered. The phone call I had lasted about 15 minutes. That was how long it took me to read off the number of each code and for the customer service representative to say, "No - not covered" for each one. I hung up, feeling disappointed that fertility wasn't considered important enough for coverage when so many couples these days resort to fertility assistance to create their families. We had agreed that we would try every avenue we could to help get this paid for by other parties before we started shelling out money we didn't have. So, we carried on...

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ISO Sperm!

Of course, people who don't have a healthy sperm-carrying partner have options when it comes to determining where the second ingredient in baby making can come from. You can go with a known donor. This might be a family member or friend who can offer up their stuff for the purpose of creating a life. We know a lot of queer couples who fantasize about this option but few who rarely go with it. There are a lot of risks - the donor later wanting to be more involved in the child's life than is wanted by the child's parents, one of the parents becoming enamored with the donor because of the relationship he now has with the family and how the child resembles him, or simply having a falling out with the person over time. For us, this didn't seem like a great option. We had a couple of people we might have asked but Rey wasn't yet fully confident in his maleness and it worried him that our kid would have two dads...not just him. I think that had we had the opportunity to make this decision two to three years down the road, we might have chosen differently but at the time, this was the best decision we could have made - not to go with this option.

The other options are sperm banks - there are sperm banks that are certified and some that are not - sperm banks for lesbians and sperm banks with only gay and bisexual men's sperm - sperm banks for Jews and there have even been sperm banks full of genius donors' sperm. Lucky for us, our clinic gave us a list of four sperm banks to check with first. You simply go to the website for the bank and browse through the profiles of the donors they are currently working with. Most banks will include the donor's ethnicity, hair color, eye color, and height on the donor search page. Once you click on a donor, you get whatever other information they have available. We found that they would typically give you a brief medical history of the donor and his family (usually going out as far as aunt/uncles and even cousins and going back as far as grandparents). They also usually had something more personal about the donor, whether that was a brief Q and A with him, or the impression as written by the intake coordinator working with him on his first visit to the bank. We would spend an entire night going through a banks website and reading profiles of five or six we thought deserved a second look.

We wanted a baby that would potentially look like both of us. While we're both short (5'1" and 5'3"), we don't look much alike apart from that. We began talking about the amazing idea of having one child from Rey's egg and one child from mine. We wanted them to be biologically related so we would choose a donor that looked like both of us as much as possible - we'd have a natural-looking family that was also linked genetically. We searched through profiles, seeking the perfect blend of Rey's and of my characteristics so we'd have a fair shot at achieving our dream. 

We also were adamant about the fact that the child have the ability to contact their donor after reaching adulthood if they so chose. Both Rey's and my mom are adopted and neither really know anything about their birth families which has caused a lot of questions and frustration over the years. We also wanted to ensure that should our child have any medical concerns, they have the ability to discuss them with this man who is giving them have of their genetic material.

On one of the first few nights of looking for a donor, we found one that seemed perfect. This particular website had an audio interview feature where you could, for free, listen to your donor's voice. Now, I'm not sure why anyone would find this feature helpful...Rey was certainly not interested in hearing the voice of the person helping to create his children. I, however, was just curious. It was available, after all! Well, I can't really remember what he sounded like...it was a bit weird though, admittedly, hearing the voice of someone who you don't know but who will potentially be yo baby sperm donor daddy!We were really interested in him but we'd forgotten to make sure he was interested in being available to the offspring after they turn 18. Upon realizing this, we went back to his donor profile and - of course - he was not interested in this. In fact, none of them from that clinic were. The clinic's policy was such that no children coming from these donors could ever find their biological father. This was not unique. We went through three major clinics before we found one that gave their donors the option for contact with their offspring if and only if the child wanted it.

Finding "the one" and then having to let him go was really disappointing. It took a lot of energy and emotion and I was surprised at how drained I felt and how frustrated I was that we'd have to start all over again. But then again, we hadn't been looking all that long to begin with...it just felt like it!

When we got back online to look again (a few nights later), we soon found another guy we thought was perfect! He was physically a very good mix of our characteristics and his family history didn't have a great deal of medical issues that we would need to be worried about. He was a Buddhist and vegetarian he loved nature - just like us! We got to see his baby picture and he happened to look a lot like Rey in his baby pictures. Even still, it took us a few nights before we decided that he was the one. I looked at my paperwork from our clinic to make sure I was getting all the details right before  buying something that doesn't come with a gift receipt! We needed sperm for IVF, it said. This seemed self-explanatory since that was the procedure we were planning to have. But upon return to the donor site, I realized there were different prices associated with different kinds of sperm. Different KINDS? I had no idea...You could get ICI, IUI, or IVF. I would find out later that one type was frozen sperm, no semen and another was sperm in semen that had been "cleaned". This was where someone had gone in and removed all dead or super slow moving sperm so that the best and brightest were the only ones left in the vial. IVF required regular old, traditional, out of the dude and into the cup sperm. 

I called one day during my lunch hour at work to order the sperm. The woman on the other end of the phone said, "Oh, honey...I'm so sorry but he's all sold out of the IVF vials. Someone just bought the last one." I was dumbfounded. It was hard to fully understand that this had happened again. That we'd have to look for "the one" again! It took so much time and consideration to finally find someone good enough to go with... "Can't you call him and ask him to donate again?!" I pleaded out of desperation. "Well, we can try...we would call him and ask if he'd do it again and if he would, we would give the sperm directly to you. However, just so you know, it would cost $1500 to make that call, and there's no guarantees that he would agree...plus the cost of the sperm." I couldn't speak. They'd charge me $1500 to dial his seven digit number? I hung up disoriented and in disbelief.

Needless to say, it took us awhile to get back online after that. It was about a month before we sat down together to check out other sperm banks we'd not yet visited. "They say the third time is the charm, right?" and with that and the clink of two wine glasses, we were back to the business of finding a donor for our future babies. We soon came upon a donor who had a very eclectic mix of caucasian ethnicities, was rather short, had a PhD, and had a fairly clean medical history. We also loved him because of how much he clearly cared for all the women in his life based on his notes of them and their lives. He seemed down to earth and real. He had smoked marijuana and he admitted to having had depression - both of which we could identify with and both of which were rare admissions in the world of sperm donation.

It was the next day when I got up the nerve to call for his childhood photo. "Oh you're in for a real treat! It's a great picture" said the woman on the other end of the phone. Sure enough, five minutes later, we were looking at the cutest and happiest kid ever! A couple of days later, we'd decided to go for it. I called on my lunch hour to order the four vials of sperm we were advised to get so that we'd have one-to-two for fertilizing Rey's eggs and at least two more for my eggs. The woman answered, I gave her the donor number, and she said, "OK, how many vials?" "Four of the IVF," I said. "Oh," she said. "We only have one IVF right now. I'm sorry." No...no...no...no...This was not happening AGAIN! "But I went to the website just three days ago and you had enough then. She said, "OH, can you hang on just a second?" "Of course". I waited, wondering what could have been so important that she had to put me on hold at this critical moment in my life. I waited and waited for what felt like five full minutes. She came back on the line a little out of breath and this time, she said with a smile, "You'll never believe it but just today, five more vials of IVF became available! We'll put your name on them if you'd like!" And before we knew it, we had bought four vials of sperm which would be overnight-shipped to our clinic within the week. Baby-making ingredient number two - acquired!

Sunday, July 29, 2012

Our Intake Experience - Part 2

We sat opposite a straight couple in their forties who seemed somewhat sad as we waited to be called in for my ultrasound. It hadn't occurred to me until then that people typically went to a fertility clinic because they were so frustrated with not having been able to conceive. And while this was a last ditch effort for so many people, this was our beginning. Among these upper class, straight socialites, we were the privileged ones.

As my balloon of excitement slowly deflated at the thought of these other couples and their emptiness, we were called back for my ultrasound. I was surprised to learn that apparently they do them intravaginally these days. I laid stiff as a board on the examining table while I waited for the ultrasound tech to prepare for the procedure. For weeks now, I had worried that I might find out during this ultrasound that I would never be able to carry children. It's not that I'd ever had any indications of that being the case; it just seemed like the most perfect punishment that life could offer. I had always known I wanted to have kids, but I had never been in the right place to do so. Now I was finally ready to find out what baby making potential lived in my loins, and at the same time, I was overwhelmed with the fear that I would get a dreadful answer to that question; that I would be back out there in that waiting room feeling the same pain and sadness as the empty, frustrated couple.

 The ultrasound tech was gentle and the procedure didn't hurt as much as I'd anticipated. She worked quietly, saying nothing as she snapped pictures with her machine. We had no idea what we were looking at on the screen - it looked like one blob after another; one big, one small; one black, one white. I hoped that the objects she was taking pictures of were intriguing to her because she liked what she saw, rather than the opposite, but I dared not ask. When we were done and my pants were back on, we were led to a third waiting room. We had barely sat down there when Dr. Michael Glassner walked out of his office and introduced himself to us.

We had seen wall mounted newspaper clippings and Philadelphia top doctor's awards which had his name on them in the office where we did the intake with the other doctor earlier in the appointment. He was a pioneer in cryo-freezing embryos. He had been on 20-20 and he was now shaking our hands. He had every right to be pretentious but with just his firm handshake and soft, gentle expression, we were put at ease.

We walked in and, to our surprise, the other doctor who'd conducted the intake with us at the beginning of the appointment was there. She smiled widely at us and I got the sense that everything was in very good hands. Dr. Glassner sat across the desk from us and said flatly, "I'm going to help make all of your fertility dreams come true". There was something generic about the statement that made me question myself and my prior feelings of ease and comfort, "Is this guy for real? Is this a commercial?" And that's when he said, "I read through your chart, I spoke with my colleague here, and it sounds like you're a committed couple who has worked really hard to get where you are- I know you must have a solid relationship. You deserve to have this and you shouldn't have to put your life on hold for it any longer."

I was staring at him and tears began falling uncontrollably onto his desk. He was the most compassionate doctor I'd ever spoken with. I had prepared myself for a doctor who would make insensitive comments and make us feel small for even thinking we could do this. Rae was stroking my back and smiling. I was shaking my head and wishing someone would pinch me! All of a sudden, I remembered that none of his compassion would matter if my uterus wouldn't carry a child. "Was the ultrasound ok?" I managed to get out. "Yes. It looked good", he replied.

I wept harder and someone passed me the tissues.  The question that was weighing on my mind came spilling out, "How much will everything cost?" He explained that the cost varies depending on the amount of medication Rae would need (which would be determined closer to the procedure date), but that it was between $9,000-$15,000. Although, that was much more money than either of us had at the time, that was the price of a cheap car. I didn't have a car, I reasoned in my mind, but if I needed a car, I would buy one. So, why then, would we not commit to spending the same amount of money to create a life? "And," he shared, "there are cost-saving measures we can take to significantly reduce the costs associated. He listed a few major ways couples can lighten the financial load and I was convinced we could do this!

He smoothly transitioned into a description of the procedure and our options. On the day of Rae's period, we would call the office and set up an appointment for the next day to come in, get another ultrasound and our instructions for the next two weeks. Rae would be taking a series of injections for ten to twelve days. The injections would overstimulate the production of eggs and also keep him from ovulating too soon. The grand finale would begin with an intramuscular injection of HCG which tells the ovaries to go ahead with releasing the eggs. Following that injection, we would head back to the clinic for the retrieval of the eggs. It used to be much more invasive but they now do it all lapriscopically. He stopped and said, "Now, some choose to retrieve and freeze eggs, but freezing embryos creates the best possible outcomes. Thawed embryos are much more viable than frozen eggs." I hadn't even considered that we would need to find a sperm donor so soon and the thought of it was quite daunting. I tried to quiet my mind long enough to find out what would happen next. He described that on the day of the retrieval, Rae would go under anesthetic, they would remove all of the mature follicles and inject the sperm into each one. They would let them grow and divide for three or four days and then freeze the most viable embryos.

I was in shock. Seriously dumbfounded. We had the ability to freeze tiny babies for later in life, when we were good and ready to be parents. I couldn't stop crying and so instead, I apologized for the continuing tears. "It's ok, Jen", Dr. Glassner said sincerely. The other doctor just smiled simply in my direction. You know that feeling you get when you're completely at peace? It might come when you're sitting on the beach with a loved one at sunset or when you're reading your favorite book on a cool autumn afternoon. That feeling was all around me. I felt like there was a warm blanket all around us and that we were protected from all the evils in the world.

As I stared at him blankly (still slightly shaking my head), I heard him say, "Rae, we want you to have an ultrasound today". I guessed he hadn't heard our plan. "Well," I explained, "We were going to wait to find out how much everything would cost and then I could call my insurance company to see if it would be worthwhile to get him on my insurance. After that, we could come back for the ultrasound. Would that be ok?" The two doctors looked at each other and said, "No, we want you to have it today, Rae". I took in a deep breath. And then Dr. Glassner gave us yet another gift, "It's on me," he said. The other doctor gave him a surprised look and said, "You're really trying to get the gold star today!" "Well, it's the first day of Hanukkah", and he smiled genuinely. "My son's not getting anything today because of this, but that's ok," he joked. We all laughed and Rae and I thanked him profusely.

They led us back to waiting room number two where we waited again with the sad couples. This time though, we couldn't hold back our ecstatic amazement. It wasn't long before Rae was in position on the examining table and the probe was in showing us what his fertility potential looked like. Again, the tech didn't talk while she clicked the mouse and moved the probe about. This time though, I wasn't worried. I felt like a million bucks! We headed to waiting room number three where Dr. Glassner met us with the ultrasound pictures in hand and said "They look great. You both look good - though I like these last pictures better, you both look good."

Friday, May 18, 2012

Our Intake Experience - Part 1

Hello again, everyone! 

Before I get into this next entry, I just want to give a huge shout out to everyone who's following our journey! Part of the reason why I wanted to share our experiences with the world here was because of the lack of information available to trans/queer people on the topic of fertility. As proof of this, over the last month, this blog has had nearly 150 views and it has steadily risen to the top of the second page in a Google search for "transgender fertility". It feels as if we're climbing a mountain that very few people have climbed and charted! It's so exciting! 

When I last left off, I was just beginning to describe the relationship I have with Rae and how we got to where we are now. The background information seemed very important but I'm sure you're chomping at the bit, waiting patiently for what happens to your protagonists next. No more nail biting - I won't make you wait any longer! 

We started to do research in October 2011 on In Vitro Fertilization (IVF) and how we might be able to create a family.  We looked at YouTube videos explaining the science behind the procedure, and blogs written by mothers who'd used the procedure to get pregnant, and a whole slew of other sources - anything we could get our hands on! But not one video, blog, or website described our exact situation: One partner about to transition from female to male and go on Testosterone therapy but before doing so, has his eggs harvested so that his partner could carry his child later down the line. It was hard to imagine that this could even happen for us without having seen someone else with the same circumstances having already successfully accomplished our goal. But we pressed forward, thinking that scheduling an intake appointment at a few fertility clinics wouldn't be that costly and wouldn't lock us into anything (emotionally or financially) in case we couldn't do it for one reason or another. 

It was the middle of November when I took off work one day with the intention of staying home with Rae, making phone calls that had to be made in setting up intake appointments at various clinics. We were both so nervous to begin making the calls because of the way we imagined we'd be regarded by the administrative staff at each office. I was working on preparing myself for them telling us we they wouldn't work with us - end of story. . . preparing myself for them treating us unfairly. We were so nervous, we avoided it for as long as we possibly could! We lazed around all morning and then eventually headed out for a cup of coffee in the early afternoon. Before we knew it, the end of the workday was approaching and we still hadn't made any calls! 

As part of the research we'd done, we'd found three fertility clinics in the Philadelphia area that appeared (from their websites) to be open and welcoming to LGBTQ (Lesbian, Gay, Bisexual,Transgender, and Queer) clients. Standing in our kitchen with all of our questions written down in front of us, we might have done 'rock, paper, scissors' to see who had the incredibly stressful duty of making the first call. It wasn't long before Rae let out a deep breath and made the first call. As he spoke with the receptionist, clumsily stumbling over the details of his transition and our fertility hopes and dreams, I studied his facial expressions and tone to try to ascertain how this conversation was going from the other end of the line. He scheduled the appointment and as he hung up the phone, a slight smile crossed his face. One down! I made the second call and Rae made the third. Although the experience was definitely complicated and stressful, it seemed we had really made a bigger deal out of our situation than the clinics were making when we spoke with them! They seemed to have at least a general understanding of transpeople and fertility options - which was way more than we expected when starting out on this journey. Our appointment with MainLine Fertility Clinic offered the earliest intake appointment we were able to schedule and even at that, we would still have to wait for nearly a month for the appointment. In the meantime, we had plenty of paperwork to complete! 

On the day of our first appointment, we came to MainLine Fertility with a page full of our pre-prepared questions on the larger issues - details on the process itself, cost, time required, etc. Since this had been one of the clinics Rae had spoken with over the phone, he'd made the appointment in his name. Rae let the receptionist know we'd arrived. She asked for the insurance card which I presented. She looked a bit confused and said "I need Rae's insurance card". I wxplained to her that we weren't sure yet if we would be going through with the procedure yet so for now, I was the only one in the relationship that had insurance and since this procedure also involved my fertility, I figured they would be able to bill my insurance for the visit. She gave us a solid two or three minutes of huffing, eye rolling, and your run-of-the-mill bitching before saying it would take her a long while to make the change in they system that would allow her to take my insurance but that it could be done. By the time her episode had come to a conclusion, we were discussing whether we should take it as a sign that working with MainLine might not be what we had hoped. I remember looking at Rae and saying "We can go. It's ok. We'll find another place that will respect us". He patiently said, "Let's stay and see what happens". 

They soon took us back into an office where a doctor sat down and explained that she would be conducting the intake with us. We went over all the details of our registration paperwork and reiterated our situation. She didn't blink an eye with the information we gave her about Rae's transition. In fact, she used appropriate terminology and didn't once make us feel as if she or MainLine would be ill-equipped to work with us. Not only was she obviously knowledgeable of transgender and queer fertility-related issues, she listened carefully to our personal story and eased our concerns with a professional and empathetic bedside manner that is so rare today. 

After hearing our story, she said "We're going to want you both to have ultrasounds today". I was taken aback. I thought this was just an intake appointment! She explained that they do the ultrasound at the first meeting so they can know the likelihood of a successful experience with their office as early as possible. That made sense to me but Rae didn't have health insurance. Technically, my place of employment would allow me to put Rae on my plan if we registered as domestic partners with them, but if you're not a married heterosexual couple in the great state of Pennsylvania, a partner's insurance coverage is taxable and the amount of money we would owe for taxes on the insurance (along with the outrageous cost of the insurance itself) had always been far too great for us to justify getting it for Rae who rarely needed to visit a doctor.  

So until this moment, my plan had been to come to this intake appointment, get more information on the cost of the procedures, and then consult with the insurance company to find out if it would be worth it to get Rae on my plan. After thinking on this, I finally responded to her statement, "Well, we can go ahead with my ultrasound today and then if we decide to go through with the procedure, we can come back and get Rae's ultrasound done since he doesn't have insurance right now". She seemed satisfied with this and she escorted us to a second waiting room, where we anticipated the moment I would be led back to figure out if I would one day be a good candidate for carrying Rae's child.

Monday, April 16, 2012

It's History!

I was 24 and in graduate school in 2005 when I realized that I liked women. What an amazing time of self-discovery - I remember being euphoric at the thought of finally being able to explore this part of myself that had been hiding just under the surface for so many years. Of course, there was also fear and sadness wrapped up with all the excitement. The fear revolved around the coming out conversations I would be having with my coworkers, friends, and especially with my family. And I was sad about leaving the comfort of straightness where one doesn't have to worry about harassment or discrimination or even just looks of contempt that I was preparing myself for in the small Missouri town that I had called home. But an even greater (and more surprising) sadness came from the thought that I would never be able to carry my partner's child. This upset me so greatly that I began to weigh it as a reason to stay in the closet. I remember talking to my girlfriend at the time about this and she was clearly not concerned, "You can always adopt or go to a sperm bank" she would say convincingly. But for me, this was a life experience that I did not want to pass me by. It took me a good few years or more before I was able to handle the thought of not being able to get pregnant after a night of making love to my partner.

I moved to Philadelphia in 2006 for my first professional position in my field. What a change from the rural Missouri LGBT community I had become a part of! I felt overwhelmed with the countless establishments, events, activities, and resources for people like me in the city. About six months later, one of these new resources, Craigslist (ha!), provided the ability for my partner, Rae, and I to come together. That was more than five years ago, I'm proud to say.

Learning Each Other

Sure, it sounds clich̩, but I knew I loved Rae when I met her. In terms of appearances, she was a young, strong, handsome, pierced butch woman Рthe kind of woman I was definitely in search of. I was drawn immediately to her silly sense of humor, happy-go-lucky attitude, and outgoing personality. She boasted of wild teenage years and surprisingly supportive parents. She impressed me with her drive to make a living of her art, regardless of the societal stigma associated. I admired her for all of these reasons and felt inexplicably connected to her from a layer deep within myself.

Over time though, I noticed that it didn’t take much to get under Rae’s skin. This bright and talented creature had a temper that could ignite a flame. As a result, we had difficulty solving the simplest of discrepancies as a new couple. It always seemed to come back to her indecision of whether to go with the fight or flight response, rather than just to cool down and work it out. Not only were we dealing with the challenging anger issues, but there were also frequent, unexpected bouts of depression that would last days, sometimes weeks, on end. While I admit there were definitely still good days for us, I found that I was most often taking up a second job, apart from the one that I got paid for: being Rae’s personal cheerleader. I wanted nothing more than for Rae to just be happy and return to the driven, independent, and gregarious person I fell in love with not all that long before. I continued in that self-designated role, managing to motivate my fragile partner back onto her feet occasionally and keep our relationship (that I so cherished) afloat.

It was early in the spring of 2009 that, as a reviewer of a local LGBTQ film festival, Rae brought home a multitude of movies for us to watch. A few of them specifically focused on transgender children. I remember watching these films, thinking of all of the connections between the kids and my loving partner sitting by my side. I wondered silently whether Rae had ever thought of changing genders but I dared not ask since I did not know what I would say. From those films though, it was clear that something changed. We discussed gender endlessly for months. Sometimes gender was literally the only topic of conversation for an entire evening. All the while though, Rae’s gender was still this enigmatic thing. She didn’t seem to know quite how to define it until that December when she patiently explained that she didn’t want to be a woman anymore and that she’d rather identify as a Transman. As his partner, I was shocked and yet I wasn’t. This had clearly been on its way for months and so to some extent, I was ready for the news.

As we each began tackling all of the emotions that accompany this kind of realization, we were brought closer together than ever before. I felt as if I was starting to really see my partner for who he'd been all along. He began to appear more at ease with himself and more productive in his work. For a while, there was a regular sense that it was two steps forward, one step back as the tumult of sadness, anger, frustration, and restless anxiety for what was to come would creep up and steal the show for one or both of us. However, the farther we progressed together on our journey, the more we learned about what we each really wanted out of life and what we were willing to do to get it.

Identifying as a Parent-in-Waiting

Since I was a little girl, I can remember thinking I would eventually have children. I think there were a handful of years when I was in college when I might have denied ever having had those thoughts (!), but other than that, I have always wanted to be a mom. When my former college professor and good friend, Debbie, had her first child in 2005, I was overcome with an intense love for this little being who wasn't even related to me. I wanted to take care of her all the time and I cherished the moments we had together when Debbie wasn't around because the responsibility for making sure she was well taken care of and happy was so insanely gratifying.

Since probably the night I met Rae, he knew I had plans of becoming a mom. His response for the first couple of years was "That's not for me". And for the time, that was ok as I had no idea if we were going to make it that far anyway and I knew that I was going to be waiting for at least five years before I was ready - so we had time to either work it out or move on. Over the years, he would meet my friend Debbie's (then) two children and other friends of both of ours began having kids as well. After we'd been talking about his gender identity for a while - maybe six months - it slowly started to creep into our conversations that he might one day want kids too. This shocked me! I couldn't really believe it so anytime it was brought up, I made him elaborate on what parts of being a parent he thought he would like or dislike the most, etc. But I knew I couldn't dwell on it for too long since I didn't want him to change his mind! It was some time later when he told me that he'd had the realization that he had never been able to see himself as a mom but that seeing himself as a dad made a lot of sense to him. He was finally able to visualize a family of his own.

With that, came many more exciting and painful conversations about my personal queer invisibility in a marriage that looks quite "normal" and straight. We spent a lot of time on the traditional vs. the more non-traditional roles of a husband and wife, children, and of the family. We understood that we were really designing the structure of something more permanent - something that we wouldn't fully see the shape of for some time. However, we hadn't made any real commitments and although I knew Rae's truth, few other people did and so we had a lot of work to do before we could even think about having children!

Hormone Replacement Therapy

Until this point, Rae had been adamant against the thought of going on 'T' (Testosterone) as a way to align his gender identity with his outward appearance to the world. I think he thought that by having top surgery (essentially a double mastectomy), his flat chest and his masculine facial features would speak for themselves and he wouldn't need to take the hormones in order to pass as male. In 2011, he began binding on a regular basis and we came out to just about everyone we knew about his transition. However, through the course of coming out, he earned the acceptance and respect of nearly every coworker, friend, and family member known to both of us, as he carefully explained his story and patiently guided everyone through the process of using the pronouns that didn't use to refer to him. As he was doing this, he was met with such love and understanding from those closest to him and yet people who didn't know him at all would use incorrect pronouns and make him feel as though he was still the misunderstood, sad, and lost girl he had been for so long.

After much deliberation, weighing all of the pros and cons so carefully, he decided to go on T after all. This was not a shock to me, so it wasn't hard dealing with the information, but since it is impossible to truly know how your partner will look, think, and behave after going on the powerful hormones, it was a bit nerve racking just thinking about the innumerable possibilities. However, a part of me was really excited for the changes and for the world to see the man I was starting to see and learn for myself.

Future Plans

In October, on a road trip through beautiful North Carolina, Rae asked me to marry him and of course, after putting my heart and soul into our relationship for nearly five years, but especially the last two and a half, I couldn't say no! We had worked hard to carve out a place for ourselves in the world and I wasn't about to go anywhere anytime soon!

Around this same time, one of our friends who is an FTM (Female-to-Male) transsexual asked Rae if he'd ever thought of freezing his eggs before beginning T so that he could one day have the ability to have a child. This particular friend had unfortunately not had the opportunity to do so and was now a bit regretful that there's no way to go back and do it now. Testosterone essentially destroys your eggs while you're on it and while some of the other changes go back to the way they were before if/when you stop taking T (menstruation returns, body fat redistribution, etc), fertility is one area that most often never returns to full functionality. Rae and I hadn't really talked about this yet but the idea intrigued us. I think too that the more we talked about it, the more excited we got at the thought. Rae didn't want to carry the child so we'd be freezing his eggs so that one day I could be the one carrying them. I would be carrying my partner's child...! Was this really happening?! There was a time there when I wasn't able to think about the possibility of this because it seemed so far out there! After all, we hadn't even had a consultation yet so we had no idea about the real likelihood of all of this working out for us.

And this is where our fertility journey began. Rae's new found identity has helped him to achieve a sense of self he must have been subconsciously searching for all along...becoming a dad!

Wednesday, April 4, 2012

Brief Introduction to the Blog

Hello world! You all know a bit about me and my partner, Rae, by now from my bio. We are putting the pieces in place now so that we can preserve Rae's eggs before he begins taking testosterone as a measure of aligning his physical appearance with his gender identity.

I wanted to write this as a reference for people everywhere going through what we're going through as there doesn't seem to be much information out there...My mom also made it explicitly clear that we would regret it if we didn't document our experiences!

So I will be sure to write more later but this is the beginning of our journey! Come on along for the ride!