Featured Voices: Male-Assigned NonBinary Medical Transition

For this month’s Featured Voices I interviewed fluffy to talk about their experience with lower surgery as a male-assigned agender person.

Male-Assigned Medical Transition

How would you describe your gender?

Agender/neutrois, trending slightly feminine.

How long have you been unraveling gender? 

Even when I was very young and didn’t really understand gender per se, I figured I’d grow up to be not-a-man. In high school was when I started to feel a huge disconnect between my body and my self. Of course, I grew up in the 80s and 90s, when transsexuality was (even more than now) just a mean-spirited punchline in trashy comedy shows, which of course led to internalized self-loathing and a constant fear of expressing myself.

fluffy: real-life me sitting next to avatar-me
fluffy: real-life me sitting next to avatar-me
You’ve been through primarily a medical transition as a non-binary person. Can you briefly talk about hormones: what are you taking, how much, for how long? And what changes have you seen?

I’ve been taking a fairly low dose of estrogen for quite some time – on and off starting in 2004, and full-time since 2011. The primary effects have been the growth of breast tissue and a general redistribution of body fat. Recently I went up to 4mg/day of estradiol, but that caused my blood chemistry to go out of whack and so now I’m back to 2mg/day.

For a few months in 2011 I was also taking spironolactone (a diuretic, which is used off-label as an androgen antagonist) although the primary effect of that caused me to get dangerously dehydrated and constipated.

Talk to us about lower surgery. Which surgery did you have and why did you seek it out?

I had a bilateral orchiectomy – a removal of the testes – two years ago.

I was tired of the constant nagging feeling caused by testosterone. My time on spironolactone had proven to me that not having testosterone in my system would make me feel quite a lot better, and not being able to take it left me with this constant dismal feeling of inner conflict. Pretty much classic dysphoria.

How long did it take from the moment you decided to pursue surgery until you finally got it?

Many, many years. I started to want it in college (late 90s), and the feelings only intensified over time. I always felt very timid about actually pushing forward on it, though, and I never really got the courage until I was living in San Francisco a few years ago.

What were some of the biggest obstacles you encountered during the process?

The research for the actual procedure was pretty straightforward. Finding a doctor, however, was not.While San Francisco has a reputation for being queer-friendly, it’s somewhat overstated and really only there for white cisgender homosexuals. In particular, I found that doctors have issues with DMAB-based gender stuff; practitioners want to really cover all their bases and adhere strictly to often-outdated standards of care. In particular, the surgeons I talked to there refused to do anything to me without me being on androgen blockers for a whole year to make sure I was really, really sure. And of course, I couldn’t actually tolerate any androgen blockers.

When I moved back to Seattle, however, it became really simple and straightforward. Washington state doctors embrace the informed-consent model, WPATH standards had been updated [2011], and Seattle is a very trans-friendly place. My employer at the time even had healthcare coverage for transgender care, so I didn’t even have to pay very much for it! (Although I would have happily paid out-of-pocket if I had to.)

What options or other types of medical transition were or are you considering, and why?

I’ve always been considering full genital nullification, as the hormones aren’t the entirety of my dysphoria; I also feel like having a penis is completely wrong for me. I am still considering it, although finding practitioners who will do it is difficult, and the surgery is known to have several complications as well. Another possibility is to simply get a “standard” MTF surgery and simply not bother to dilate, but that seems like a pretty big step to take as well.

Also, I still present as male at work, which means still using the men’s restroom, which in turn means having a lack of stalls – being able to pee standing up is often an unfortunate necessity (not to mention it’s also rather convenient).

I’m often considering some level of facial feminization surgery, in order to be read as less masculine, although that’s a major undertaking. I’d also like to find a good vocal coach to sound less masculine when I speak; I’d consider a procedure to modify my voice if there were one which wouldn’t destroy my singing voice.

How do you feel about your surgery now, two years later?

I wish I had done it much, much earlier. One of the problems with testosterone is that a lifetime of exposure to it makes it very difficult to overcome its rather permanent effects. My voice and facial structure are very distinctly masculine. I had also done laser hair removal for several years – an expensive and painful procedure – and this would not have been necessary if I’d never been subjected to this.

The only dissatisfaction I have with the procedure I received is that I still have an empty scrotum, which is a specific source of dysphoria for me. I could have had it removed at the time of the surgery but if I had done that it would make MTF surgery much more difficult and I wanted to keep my options open.

How has this impacted your life?

Everyone who knows me well thinks I’m far happier and better-adjusted since the surgery. Even the people who don’t know about it. My therapist said, “You no longer always look like you were hit by a truck.” Even my mom (who I haven’t told about the surgery) has noticed a marked improvement in my mood and outlook since then.

It also has helped quite a lot with my frustration. I’ve always identified as asexual, but of course testosterone is the primary driver of a sex drive – and while mine was weak, it was present enough and had no outlet.

On the other hand, now I’m a bit more sensitive to jokes and everyday expressions regarding male gonads. I’ve started to realize just how much American society equates virility with… well, everything implied by virility. This is especially bad working in a STEM field, where everyone who is male-presenting is also assumed to be heterosexual and cisgender, although my current coworkers are generally better about this than most places I’ve worked. I might even feel comfortable enough to come out at some point!

On that note, the main reason I haven’t yet come out at work or transitioned or anything is that I’ve had a hell of a time trying to find a name that works well for me. I mean, all my friends know me as “fluffy” but that’s not a particularly suitable name for professional life.


How has this impacted your gender – your own identity, how you express it, how you feel about pursuing transition in other ways?

There’s an odd sociological aspect where it’s relatively easy for DFAB people to be nonbinary presenting, but for DMAB folks you basically have to go all-or-nothing. I happen to like my ostensibly-unisex mode of dress – jeans/slacks, a t-shirt, and a plaid overshirt (my therapist calls this the “PNW lesbian” look) – and I don’t really see the point in trying to look more feminine. I’m also not one to stick out or draw attention to myself; if I could just wave a magic wand and have everyone refer to me with gender-neutral pronouns and honorifics I’d be happy. It’s not something I want to fight for. I don’t want to be an activist, I just want to be me.

Also, among the non-binary folks I know, most are DFAB, and don’t have any specific desire to make a big deal about gender, but they are in situations where they don’t need to, either. People just accept them for who they are, in general. One of them actually does do low-dose testosterone and is far happier that way.

Of the DMAB non-binary folks I know, most of them are either stuck in a similar rut to me, or decided it was easier to transition to female instead of trying to be in the middle. Even my therapist in San Francisco, who was a trans man and worked a lot with non-binary people, found it very surprising to have a DMAB non-binary client; he’d only seen it in FTMs and other transmasculine people.

There’s something a bit sad about how society sees masculinization as an upgrade and feminization as a downgrade; the former is something that’s okay to play with, the latter is something that has to be all-or-nothing and gets incredibly politicized (of course, none of these are true). I’ve even been attacked by highly-political transwomen for somehow “cheapening” their struggles!

There’s a strange belief that non-binary people don’t feel dysphoria, and that dysphoria is the be-all end-all in a trans identity, and that a non-binary identity is just “playing with” gender and not taking things seriously. It’s also a bit frustrating how there seems to be a non-binary “uniform” in terms of how they are expected to dress and present themselves and even what haircut to have. Sometimes my mom even sends me links to articles entitled “This is what non-binary looks like” and asks me when I’m going to dye my hair.

Did you ever know of or meet anyone who had a similar procedure?

Not that I know of. However, I do know several others who would like to undergo it. And, of course, I do know several MTF transsexuals who have said they really identify as neutrois but found MTF to be a path of less resistance.

Can you recommend other sites or resources for people who are interested in this option?

While nonbinary resources in general seem to focus on the DFAB experience (probably because of the same sociological issues I mentioned above), there are still some useful things. There is an amount of useful surgery-related information at eunuch.org (although I would take much of it with a grain of salt, as that site primarily focuses on fetish fiction), and AVEN (asexuality.org) has some resources as well. Susan’s Place (susans.org) has plenty of trans resources in general, including nonbinary, as does the Ingersoll Gender Center (ingersollcenter.org) which is here in Seattle (about a block from my house, actually). Mytranshealth.com is currently under construction but will have a lot of information for non-binary people, especially where to find helpful therapists, and a good therapist can also help you to find surgery resources.

What advice would you give to your younger self?

It is okay to talk about these things with adults, and it is okay to try to be yourself.

Don’t put your career and your family politics ahead of what you really need.

You will spend far more time regretting what you didn’t do than worrying that what you did do was the wrong choice.

Also, Seattle is awesome and you should totally live there (btw, don’t sell that Apple and Amazon stock.)

What advice would you give a non-binary person just starting out in their gender process?

Everyone’s journey is different.

What is right for one person is not necessarily going to be right for you. And that’s okay. As a society we’re just starting to remember that everyone is different, and self-expression is vitally important. It’s also okay to change your mind about things as you figure things out.

This stuff’s complicated, but it can also be really simple.

An update from fluffy, ex-post-posto

I COMPLETELY FORGOT TO MENTION in the original article how I’ve been doing laser hair removal for years. It’s painful, but worth it, and was instrumental to me no longer feeling so detached from the person I saw in the mirror. Finding a laser hair removal clinic is pretty easy and they were all very accommodating. In particular, I’ve been very happy with Epicenter MedSpa in San Francisco and Kucumber Lounge in Seattle.

I have settled on a name (finally) and am going to actually publicly transition (finally). I still plan on going by “fluffy” online but having a name I’m happy with makes a huge difference for real life.

I’ve also come out to a couple of coworkers and have been getting a huge amount of support and encouragement from them.

About fluffy

As a software engineer, artist, and musician, the person known as “fluffy” has a natural tendency to blur lines; gender is just one of them.

non-binary-youth-2015-imgs.004Greetings, Awesomeness

Get a badge of awesomeness and warm feels for supporting Featured Voices at patreon.com/neutrois.

9 thoughts on “Featured Voices: Male-Assigned NonBinary Medical Transition

  1. Thanks so much to fluffy and Micah for sharing this. It is so hard to find other AMAB enbies.Very inspiring to know there are others with experiences similar to mine.

  2. Wow, I’ve already been getting a lot of positive response to this article. Thanks, everyone! I do have some updates to share since this was written:

    1) I’ve finally decided on a name
    2) As such I’m also feeling ready to actually transition in public
    3) Also I’ve been coming out to trusted coworkers and getting a lot of support there too 🙂 so I might be doing an on-the-job transition soon as well!

    Thanks for giving me an audience, Micah, and thanks everyone who’s responded so far!

  3. wow, wish I had known you or had a chance to talk with you 20 odd years ago before I began my journey , I went the other way though FTM … back then here in Canada it was all or nothing, didn’t really have the lets play with gender until we find our happy place option , when I turned down the bottom surgery my doctors were less than happy , ah well that was then, this is now, just wish I would have known there are options and you do not have to go full tilt one way or the other, there are a few things I might not have done if I was given choices and options.

  4. Fascinating, Fluffy is the first AMAB non-binary person, I know of, who transitioned in this way, (not that there are a lot of examples). I don’t know what choices I’d have made had I been aware of non-binary gender identities when I was younger. As it is age has given me low testosterone so I don’t have to make that decision. For me social dysphoria has always been a bigger issue. That’s probably why I mix in clothes our society has deemed “women’s clothing.” I like to think of Agender as freeing me up to be beyond gender. So I wear what I like and try to ignore the way clothes are labeled. As to your nickname not being professional; I think it’s wonderful! I was dubbed Care Bear at work before I went on disability retirement. Coworkers started giving me Care Bear plushies which now are part of my bedroom decor. I’ve decided life’s too short to worry about what is “normal.” As the saying goes, I just let my freak flag fly!

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