some thoughts on gender, boobs and belly fat

I stand by my promise not to turn this into Cheryl’s Cancer Blog, but I do have to share one of the weirder and funnier parts of this process so far: my visit to Dr. L, plastic surgeon. (Why does he get just an initial? I don’t have anything really bad to say about him, but in case any of my doctors Google themselves in their minimal spare time, I don’t want the surgical equivalent of a waiter spitting in my food, you know?)

Although I mentioned the exciting prospect of new boobs in my last post, I feel compelled to add that reconstruction shouldn’t be a given. One of Meehan’s friends was disturbed that doctors always mentioned plastic surgery before her health. And I just read this post over at I Blame the Patriarchy, about the compulsive feminization of women, breast cancer survivors like the blogger herself included.

But I’m getting new ones, even though Dr. L informed me they’ll have pretty much no feeling, which is totally unnerving (literally—ha!), because I want to look nice in clothes designed for girls. It’s that simple.

And not simple at all, of course. Given that my forthcoming chemo will be hormone-based and will shut down my ovaries, and that I have the BRCA-2 gene mutation and therefore a hysterectomy in my near future to lower my risk of ovarian cancer, and my body has already demonstrated itself to be ambivalent about getting/staying pregnant, any biological femininity I have is somewhat under attack.

Luckily I came of age in a community that believes biology is not destiny. Although of course all of this is happening because of my genes, so biology is some kind of destiny—just hopefully not the only one. If my trans friends can be intrinsically male or female regardless of their body parts, I hope I can be too. Right now I’m feeling kinda FTMTF.

This post was supposed to be about my wacky visit to Dr. L, but I seem to have digressed into philosophy and melancholy.

A nurse (receptionist? both? I wasn’t sure) took the first topless photo of my life; I stood in a very unsexy “before” pose with my arms at forty-five-degree angles. Then I put on a cheap silky gown embroidered with Dr. L’s logo, and Dr. L himself—who has maybe had a little work done around the eyes—came in and showed me dozens of pictures of before and after boobs.

There are way more types of boobs in this world than the movies or my limited sexual adventures prepared me for. And that’s just the befores. The afters were fine—plastic surgery is pretty advanced—although some of the in-betweens were a little rough. Not because they were hideous, not even because they had scars instead of nipples. Just because they were bodies that spoke to transition and hard times.

I’ve had hard times that were entirely invisible, and like a teenager who slices up her arms, the prospect of making pain visible is not entirely unappealing to me, even if the eventual goal is looking good in a halter top.

Given my type of cancer and my type of body, Dr. L recommended implants rather than “flap” surgery (was there ever a less appealing name?), in which they make boobs out of your stomach fat. He might need to borrow a little muscle from my back to protect one of the implants from possible radiation, he said, and I imagined a fig wrapped in prosciutto. But I was too thin for flap surgery, he said.

Implants as appetizer.

The breast cancer world is one of the few in which I’m repeatedly told I’m young and, now, thin. It feels stupid to be flattered by such things—I’m getting treated precisely so I can get old—but I’ll take whatever I can get these days.

“You’re very thin,” he kept saying.

It’s true that lately I’ve been on the Anxiety Diet, which is the exact opposite of the MacDowell diet, but I told him, “You say that, and it’s nice to hear, but I think I have a belly.”

When he finally opened my gown and looked at me topless, he grabbed a hunk of belly and said thoughtfully, “I could probably make a large B-cup out of that.”

Cathy pointed out that his comment was not unlike those of T-Mec’s vet in the strange-gauging-of-women’s-bodies category, although Dr. L wasn’t quite such a whackjob. We quickly returned to the implants option, though, because it’s less invasive and I want to be a C-cup, mainly so the rest of my body doesn’t suddenly look huge in relation to my boobs. Maybe I should be glad that people, even doctors, can’t figure me out just by seeing me with my clothes on.