A Real Man

Brooklyn girl grows hair on her chest

Drew plans to undergo a minimally invasive type of mastectomy in which the surgeon will make a small incision below the nipple. Through that aperture the breast tissue will be removed. Sometimes this entails liposuction, after which the incision will be stitched, leaving a barely noticeable scar behind. (The nipples will later be appropriately resized and repositioned to appear male.) For up to three months after the surgery, Drew will have to wear a compression vest that will enable his skin to attach itself to the newly exposed pectoral muscles. Then, if all goes well-and, presumably, if Drew builds a musculature he's proud of-he'll be able to walk around in public without a shirt.

"I've spent my whole life hunching my shoulders in order to hide my breasts. When I was a teenager, my parents even sent me to a doctor hoping to cure my bad posture. Last year, when I told them I was transitioning, I was finally able to tell them why I had been slouching all my life. I had always hated my breasts."

Most women must understand the enormous sense of liberation entailed in doffing one's shirt in public with impunity. When many of these women were girls, being able to go shirtless on a hot day had to have ranked as one of the most enviable advantages of being a boy, along with being able to urinate standing up.

Drew remembers this as his first childhood obsession with being like the boys. "I always wanted to pee standing up. I finally devised a way to do it in the woods, but it wasn't the same." At five, Susan was placing rolled socks in her underwear and looking at herself in the mirror. "It just seemed righter," Drew says.

Of course, believers in reincarnation have little trouble explaining this phenomenon of feeling more at home in the body of the opposite sex, but the rest of us generally have a difficult time getting our minds around it. The stereotypical explanation we most often hear for transsexualism is one in which the person describes feeling like a woman "trapped" in a man's body or vice versa. Although Drew makes a point of saying that he by no means speaks for all or even most transsexuals, he mostly subscribes to this typical view.

But there's more to it, he explains. "It's much more than skin I'm wearing," he observes, describing his situation in what seems a much more organic way. He says he opted to change his sex because he couldn't envision a future as a woman. He couldn't imagine growing old as a woman. The bottom line is that Drew wants to be seen, on the outside, the way Susan has always felt on the inside-as male.

He doesn't discount the past life explanation entirely, but he doesn't lend it undue credence, either. "I went to see a fortune-teller on the beach in Venice once," he recounts, "and I asked her about my past lives. She said that she had never seen this before, but that in every one of my previous lives I had been a man. For whatever that's worth."

Drew doesn't seem sure about whether or not he'll opt for surgery below the waist, partly because it's expensive, and partly because it's a much more involved procedure than a mastectomy. He has basically two options.

One surgery, called metaidoioplasty, would take his already enlarged clitoris (the testosterone alone has made it grow to about three times its normal size) and disconnect the lower part of it from the vulva, making it into a kind of miniature or micropenis. The surgeons would also reroute the urethra through the new phallus, thereby enabling Drew to urinate standing up. Thereafter, he could use a pump that would stretch the blood vessels and might enlarge the penis slightly. This surgery would allow him to retain sexual feeling.

The other surgery, phalloplasty, which Drew says he's not considering, entails taking a large skin graft from the inside of the forearm, wrapping it around grafted fatty tissue, and fashioning something that resembles a normal size penis. This penis would, of course, not be sexually functional or sentient, so what Drew might gain in size he would lose in performance and, to a certain degree, in satisfaction.

In general, these surgeries range in cost from $18,000 to $65,000. Some surgery may be covered by insurance; how much depends on how insistent a person is and on whether or not a mastectomy (or a hysterectomy) can be justified medically. This, of course, means that such justifications must be made before the person changes her name, and therefore her sex; many non-transsexual women undergo these surgeries for other reasons. Persuading insurance companies to cover these procedures is apparently not onerous, or there are a lot of pre-op transsexuals willing to scrape the bucks together: Of the estimated 30,000 self- labeled transsexuals worldwide (10,000 in the U.S. alone), between 3000 and 10,000 have undergone surgery.

But whatever the relative losses and/or gains involved, Drew is sure that the choice he's made is the right one. Unlike a great many transsexuals, he's been blessed with a girlfriend who was his lesbian lover when he was a woman and has been willing to brook his change into a male. That, in itself, is rather miraculous. Likewise he has a family that accepts him completely. His four sisters refer to him as their brother, and introduce him as such to their friends. His parents call him their son, and treat him like one-which means that he and his father now enjoy man-to-man chats.

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