Saturday, November 3, 2012

My Mom

oh gosh I feel so horrible. I was moving boxes around and came across one I had of my moms stuff when she passed away. I don't know why but I decided to look through it and broke down. In her purse she had phone brochures like she was looking for a wireless plan, her cigarettes, pain pills, lottery tickets, and many other things any person would have. 

A Blockbuster card in her name with a coupon for 1 Free non -new release movie rental, dated October 1 - October 31, 2005. The month she passed away. An application for WhatABurger. Cosmetics she must have scavenged or used the last of any money she had for. Soap. A toothbrush and toothpaste. There were shoes and magazines she had read, things like People and US weekly but she liked them and the books had burned in the fire. Despite how bad her condition was, inside was still was my mom, just trying to make it.

She really seemed to be trying with everything she had. The truth of the matter when s
he passed, things were so bad with her schizophrenia I had moved out. This was after the house burned up and was barely livable. I was working and school at the time trying to stay afloat. I had moved out, seemingly thinking it was best for both us. Figured I would check in on her.

I failed that. It had been almost a whole month I had not seen her or talked to her when I heard she had been hit by a car. It was too late. She had been starving to the point of grabbing the bags of donuts the donut shop threw out behind my Blockbuster. I opened an electric bill from then, past due with a cut off notice. I would have paid it.

I should have been there for her. Even as I lay by her side in the hospital, her unable to speak or move, I held her hand. It was rough, and dry and scratched by her trying to make by, practically homeless by many standards.

I saved what I could to remember her by. It has been six years and it hurts just as bad as the day it happened. Maybe I never did get over her. Maybe I never can. Why couldn't I have been a stronger person? I could have saved her. The last time I heard her voice was on a voicemail. Sachia had let me save it on a tape but that was lost.

You know what she said on it? The last words I ever heard my mother speak? While I can't remember exactly, I do know this, "It's okay. Things are going to be okay." I did not understand the context of it then. Yet now it is all I can think of. Her voice reaching out from the past to make me understand that things will be alright.

Below is the only picture I have left of her, and our dog Angel.


Thursday, October 18, 2012

A Follow Up to the Car Post

Amazing how much power this internet work as on me. This goes with the car post earlier. When it's gone I seem to go into a depression, its like all hope is sucked out of me when it goes away. I know it comes in cycles now. 

As it is right now I need to save about $400 a month to hit the goal by August. With internet work? Piece of cake. Without? Not so much. All this without a car. Assuming nothing goes wrong and nothing changes, here is how it looks.

With work earnings, the most I can spare seems to be about $160 a month. That means $4000/160=25. 25 months. 2 Years. Life sucks. Another two years of misery, after the last nearly wiped me out.

With good internet earnings
$4000/400 = 10. 10 Months. Less than a year. August. Airfare on credit card. Done. Life moves on. Anything extra is gravy towards a car, school, house. etc.

Okay now let's add in increasing costs. Seems to be about $500 a year. So on the two year plan $1000.

Bad Internet $5000/160 =31 months - 2 1/2 years. Good internet $5000/400 12.5 months - Roughly a year.

Factor in a car;

Let's say I buy a $2,000 car.

$7000/$160 = 43.75 months - 3 1/2 years.
$7000/$400 = 17.5. A year and a half.

It really is the difference from living my dreams or dying from my nightmares. I also found something I dislike Obama about. I was going to put everything on my FSA this year so I could go for my birthday in April, and stay in the states but Obamacare is imposing a limit of $2500, making things impossible here. That was one of many setbacks that made me near suicidal. To stay in America, the costs balloon to at least $12,000-$20,000. I am not going to even do the math on that.

Wednesday, October 17, 2012

Final Car Plan


so here is the final deal on me getting a car. Apologies for the long read but you all are driving me crazy ;) After this please leave me alone about it, unless you have something that will help (say a cheap car I can make payments or work off).

One of two criteria must be met to get a car.

1. I get a second job/new job/better living situation. New job = new ride

2. I meet the big goal I have fought so hard for. I am under $5000 to go, assuming the dollar does not drop, prices increase, or the world falls apart (ha). I might can hit that by this time next year, and it is one of the few things giving me hope, especially if the internet work is close to like it was this year.

3. May 2013.- Not sure I can go another summer like this last one. The burden of asking for rides, the sun, the heat, the sunburns, it's too much.

$5,000 is the magical number, money after that is the gravy train to a car and getting back in school. From Feb-Jul I saved $3000. Since then I have saved $200. Internet work has been slow since early August. It picked up the last two days, but it's only been two days.

Lastly, here are the numbers as they are now if I had a car payment of $220, and insurance of $110. Thats an extra $330. My bills are internet $60, phone $130, renters insurance $30, Rent $665, student loan $80, medicine $60, credit card $45. Total $1070 on a net income of $1500-1600 a month. Not bad, leaves me about $500 for food, expenses, fun, saving, etc.

Let's had a car I was approved for with Edmond Hyundai. Payments $220, insurance to $110. Okay $330 a month extra.

$500 - $330 = $170 for food, gas, expenses, fun, saving etc. Oh and my student loan goes up next month to $160. $110-$220 for food, gas, expenses, fun, saving etc.

SEE MY DILEMMA? IT MAKES THE GOAL IMPOSSIBLE WITHOUT INTERNET WORK, AND IF INTERNET WORK IS SLOW, I NEVER MAKE THE GOAL, SENDING ME INTO A DEEP HORRID DEPRESSION, AS EVIDENCED BY AUGUST THROUGH EARLY OCTOBER. Please see #1 or # 2. Thanks!

I made every effort to make #1 during vacation, and will continue to do so. #2 should work out over the next year, between real work savings, internet work, cashback shopping, ebaying, credit improvements (loans, line of credit), lower bills, mystery shops, and whatever else I can trim. Though if it is like August/September, this could change in an instant. #3 I don't want to think about but I may have no choice.

On the brightside, it is getting cooler now, so I will be fine. Some of my best days walking to work were when it was in the 20s. No sweat, peaceful, weak sun, etc. With the sidewalk now and crosswalks it will be even better.

Sunday, September 30, 2012

Employer Exit Strategy

This vacation has made me sure of one thing. I must move beyond my current employer. The atmosphere has changed dramatically. When I started in 2010 I was top of the world. Always asked to move, treated with respect and my hard work recognized. A very welcoming, positive place. Turnover had to have been less than 10% until mid 2011. About when everything changed.

Now I feel like I have been left to wither. No support, no care, and even when presenting the facts and truth I basically get called a liar. My manager seems to always be talking bad, even though I work hard enough to go home with lacerations, blisters, dust that has stained my hand, and exhaustion that it took my first three days vacation to overide. I would say our turnover rate is over 40% now since this time 2011. Not quite a hostile environment, but certainly a negative one.

People are leaving in droves, and just about every time it is the ones that seem to care and are friendly as can be towards me that are leaving. With the rampant favoritism that is going on I can't blame them. It is so telling when someone applies for another store, and gets the spot, yet they applied at their store and got beat out by under qualified, under experienced people. Has happened with just about 8/10 promotions lately. 

Even with my surprise interview last week, my HR was penciling in 2's & 3's before I was even done speaking! I watched the other manager interviewing me, and not only was he taking lengthy notes, he was at least putting in some 4's. (scale goes 1-5). That same day I interviewed this managers attitude towards me seemed to completely change. He had me doing all kinds of things, like he had an epiphany just how awesome I was. 

By the end of October I will be able to count the number of coworkers who are awesome to maybe ten, out of a store of 125. Which is pretty much you on my Facebook give or take one or two. Ya know, I don't think that me being transsexual has anything to do with any of this either. A lot of the changes were pre-me out at work.

There is a coming storm, and I feel the outer bands lashing at me. The one manager I get along with and is accepting of my situation will be gone when I go back Wednesday. I am not sure what will happen next and that is rather scary. For the first time with this company I feel scared about the future. Maybe the interview changed things. This manager has been completely different than the others, and I believe he has taken a much more mature, adult approach to the store, bringing the discipline the store so desperately needs.

This week has been my attempt to move forward. I redid my resume and applied for several jobs, some at other stores, other companies, even out of state places. I researched classes, reapplying to (Francis Tuttle, OSU-OKC, and OCCC).

The rule of the game was to work my way up current employer and try to get my life together. Well it is time to change the rules. When I return Wednesday it will be different. No longer will I sit idly by and put up with things. I will work as hard as I always have but I will not accept the childish bs, not to me, not to anyone else. I will speak up when things are not right and bring a bit of attitude they have not seen before. I am not this nice little loyal pushover they think I am. If they don't like it then F'em. With my vast intelligence and ability to overcome the worst that life can give, I can, have, and will do better.



Friday, September 28, 2012

Vacation Day 3

Vacation Update - Best internet day of the month! A whole $4.05. Mood is better enough I can look up again, this break has been wonderful, stress has not been this low since April. Did some basics today. Now I am down to the junk.

Working the logistics between donating and selling, which the only thing i got so far is donating my christmas tree. As for selling...uh a Gamecube game and some PSP stuff. This is harder than I thought. Last week I was solid on selling my SNES RPG'S @ $30+ a pop. Now I dunno. I have them digitally. It is absurd. Maybe I should just hire someone to sell everything for me while I leave town for a day or two. Still think I have upwards of $1,000 in old games.

Diet took a hit today, apparently McDonalds decided to have the Monopoly game this week. Well I had a medium sweet tea, 9/10 nuggets and half a large fry. Relatively speaking still better. Not trying to win millions, just need 10k or so.

Cannot believe how much my skin has cleared up, no moisturizers, just a morning scrub, even rationing out my hair vitamins has not changed anything. I think there is something in the air at Lowe's. Casual observation - Every time someone comes back from vacation/two days off they have better complexion, hair, everything. Stress? Diet? Time? Air Pollution? Dust? Sounds like a job for science.

Looks like I may go to work with my dad in the morning. Could be interesting. Thursday I plan to make a valiant attempt to recover my old hard drive, redo my resume, and apply for some jobs. Friday I will dive heavily into back to school stuff. This weekend I hope to see Looper & Resident Evil. Maybe get out and get some new shoes, need something better for work, may try something other than tennis shoes.

Hope everyone is having as good a week as I am. Most of these status updates are for reference later but people have been asking how vacation is going so I find this easier. (Plus I found a use for timeline! haha!).



Vacation Day One

Vacation Day One - A Day of R&R. Slept a nice sleep from work last night. Awoke and watched another great Doctor Who episode then had fun computer gaming. Ate at Fazzolis and some ice cream from Marble Slab Creamery. Yum.

Still stayed under 1800 calories, burned roughly 2500. Took a nice nap. Did some cleaning, then some filing and trashing of stuff watching Family Guy. A good day.

Tomorrow is Internet Work & Errand Day. Yay. Fingers crossed for lots of internet work, September has been the lowest month in two years. Posting a pic as an experiment how my appearance improves the less I work...


Saturday, September 8, 2012

My TS Life (rough draft + more background)


To someone with an open heart and open mind:

My name is Corrie Kasal. I am a 28 year old male to female transsexual. 


I am stuck waiting until my 30s for surgery. Wonder if there is anyone else out there in a similar situation. I see so many fortunate young girls, and while I am happy for them, it does hurt knowing I am going to miss out on so much, that they will get to see and experience the next few years. Everything was set to go, my surgery at the latest in 2009 (I would have been 25). 

Unfortunately, between 2006-2011 everything I had was wiped out. I was fortunate to have my electrolysis done, and have been solid on hormones since 2006 (at age 22). Funds ran dry though in 2011, and I have hardly saved up anything since. Most likely it will be 2014 before my surgery happens, I will be at least 30. Trying to overcome this, but it seems so significant in my mind. I have got to let the past go, and stop thinking, worrying about others.

Of course I always knew I was different. I hated being a boy and I did some bad things, some gross things when I was young. Even at the age of 12 I was trying to castrate myself with fishing line, even up to 17 where I hung myself by my genitals to a clothesline. I was trying to stop the incoming storm of puberty. I have worn panties as long as I can remember just like the regular everyday clothing the are.  Snuck them and took a few from Walmart until they had self checkout. Washed clothes in the sink. Simple and weird as it may sound the underwear was the achor to my thoughts until I was able to dress openly now. What I am trying to say is that in many ways, I have always lived as a girl, I just lacked the funds and knowledged to look and express the way I felt inside.

Life was hard growing up. My dad was non existent and my mom had severe schizophrenia. We were poor and did not have much. I ended up having to take care of my mom since after 1996 she took a turn for the worse. DHS placed me with my granny who was 85 at the time. Though she tried her best, I ended up taking care of her into my later teens.

 As I grew older and learned more about myself and the process I stopped, but I still have the thoughts to this day. Infections, Gangrene, and Flesh eating bacteria are the only thing holding me back, but even then I think what if. Thoughts that I cannot keep at bay much longer. So many times have I considered getting drunk, mangling myself up in the emergency room and the thought that just maybe I will survive and be rid of these wretched parts. Rationally this to me is ridiculous but the thought of another year like this is unbearable.

I started hormones courtesy of Inhouse Pharmacy back in 2006, though I had dabbled in 2003 as well. I was 22 when I started in 2006. I had just gone through some horrible times. Between 2004-2006 my mom died, my granny who took care of me since I was 12 died, our house burned up, my dog Mickey I had since kindergarten died, my girlfriend left, I lost a job, and dropped out of school. When my first really serious girlfriend left in 2006 I tried to kill myself. (overdosed on pills trying to get my ex to see me). I lost everything.

During the time with my ex I struggled with the emotions and dressing on the side. Soon as the relationship was over I hit the hormones, I knew what I had to do. I had wasted too much time already. Unfortunately I also went through the worst period of drinking and spending after this. I blew my credit, wrecked a car, and created problems lasting to this day that I don’t think it will be until I am well into my 30s to fix. Life just keeps happening and I don’t know what to do. I save up a $1,000 here something happens, save up a $1,000 there but no matter what something happens. Last it was my teeth, and before that I had to move next to work after my car died.

As of now in ten years I have managed to save up a whopping $3000 for surgery. I currently work for a major home improvement retailer. It is stable but pays the bills and that is about it. I do some internet work but that only tends to range from 10 cents a day to around $10. Typically in between on the lower end. That is where most my savings comes from. If the internet work is good then I am good, but when it is not, I see everything falling apart. I hemmorage my real job money on food, so if I can get that under control then I may have a chance.

I also struggle with hairloss still. By the time I turned 20 it was almost too late, I was stage IV. I think I am back to II now but it is still very noticeable and hard to hide unless I wear a headband or sunglasses up. Also a lot of any extra money I have is going to special shampoos that supposedly block testosterone and extracts, and the $150 I blew on a laser comb.

Another issue is my credit. I would love to just borrow the money I need and pay it back, but I filed bankruptcy in December 2011. I was fortunate to have my electrolysis finished but the debt I accumulated during 2007-2011 was just too much. My minimum payments were more than my total income. I was working a near minimum wage job and living off my then awesome credit. I knew it was wrong but I was so depressed from all the bad things that happened and being transsexual that I gave up hope that I would see the next day. Part of me stayed strong though, I maintained the job and coped somewhat. I recovered a little by 2009 but it was too little too late for my finances. I got notices of being sued and threats of garnishment I had no choice but to file bankruptcy.

Having bad social anxiety hasn’t helped. It has caused me to stress eat impacting my finances and health. I don’t have the friends and family network most have. My dad’s in worse shape than I am. He has bad back and is unable to find a job. I fear I will have to take care of him. I live by myself and just don’t make the income I need to save.  On the brightside the social anxiety helps steer me away from the adult industry. Though it is tempting for money.

I don’t have a car. This last winter I had to walk through the mud and cold through a construction nightmare. Then this summer was the same, only it was 105 degrees. Some people have been generous for rides, but I can’t ask them to help me all the time. They have lives to. It is so scary though. Mostly because that is how my mom died, just walking down the street and was struck. I think about it everytime I walk. Then what about my safety? Projecting as female now, it does bring more attention to me. What if I get mugged? What if someone tries something with me and gets a surprise? At the very least I would probably get beaten, if not killed.

Everyone I know, knows now. I used to work for Hertz, but when I came out there I started getting write-ups and disciplinary action for the most absurd things. I was working my home improvement store part time trying to save . I knew the writing was on the wall at Hertz so I promptly quit, and took this full time position in home improvement.  I waited to tell them, I could not let what happened at Hertz happen there. Eventually I could not contain it though, and changes to my body were very obvious. I came out to my hr manager, who has been extremely supportive. Most the rest of the store doesn’t seem to care.

That said, my day to day work life is miserable. Especially in summer. I see so many women in cute dresses and skirts and I drown myself in jealously and sorrow. Jealous they are so lucky they wear things like that without fear of their own parts, and sorrow that I may never get to fully enjoy those freedoms. I have not been able to go swimming since I was 15. Tucking is horrible and only reminds me of what is down there.

It is hard to checking id's and seeing female on others drivers licenses, when I am stuck with male even though I have been on hormones six years. I even tried to fight it with my original birth certificate saying female. This is in Oklahoma and I do not see that changing.

I am noticing an attraction to certain men (British haha) sometimes but feel like a grotesque freak because I know I could get beat up or worse if they saw what I had in my pants if we were intimate. I think if I was still 18 I could bear longer, but the 20s are so necessary for growing and learning about love and sex and I am missing and have missed so much already. Of course I would tell someone  first in a safe location, but accidents and spur of the moments can happen too. Mostly still am attracted to women though, though I find the thought of vaginal intercourse both appealing and correct.

I can’t sleep most nights, in fact right now I am typing this because I can’t sleep. The thoughts are overwhelming me. Thoughts I’ve dealt with for thousands of days, each day building on the next to the point I do not see making it past the next. My hopes and dreams are crushed.

That dream. Since I was little. To overcome being different and embrace it. Show the world how strong I have become.  To finish college maybe even in genetics. To find someone to love me for who I am. Adopt a child in need. Be a big sister to someone. Help others in my situation. Become the lady I was always meant to be.

Fortunately, with a note from Dr. Dawn Singleton (my counselor), I have been able to get hormones through my work health insurance. I see an endocrinologist (Wynter Kipgen) as well for checkups. This helped a little. I have my letters. Unfortunately I do not see Dr. Singleton often since that takes out of my surgery money. I miss donating blood too, can't do that while on finasteride, and I imagine it would be a year after surgery before I could.

Thank you for reading. 

With Love,
Corrie

*Fun Fact* My original birth certificate says female

Follow Up to Insurance Exclusion

While I am still researching how I plan to get surgery covered by insurance, I did email the human rights campaign (HRC) and they sent me the following links I thought would be helpful.


Thank you for contacting the Human Rights Campaign's Workplace Project.

Our main website, hrc.org, includes information and resources for LGBT employees hoping to make changes within their workplaces.
The following  links to pages on our site includes resources for transgender employees, descriptions of transgender-inclusive benefits for employees and dependents and help on how to advocate for LGBT equality in your workplace.




Hope this helps.

Tuesday, September 4, 2012

Insurance Specific Transgender Exclusion for Surgery

I recently pursued the avenue of using my employer insurance (Aetna) for gender reassignment surgery. I met all the prerequisites, have my letters and this is the last step in my transition. I have been on hormones for six years, and they are covered through Express Scripts. Name change is done. As for the surgery itself, everything started off great.
The surgeon graciously offered me a discount and initially that would come out of pocket anyway.We filed and initially it came back excellent, all I would pay is the surgery fee itself, transportation, and staying there for one or two weeks to be checked on and part of that would be reimbursed. It was expected to cover the hospital stay as well. Of course later I received a notice saying it was not covered, and that my employer in fact has a specific exclusion in our policy. This struck me slightly odd, as I noticed my employer does have gender identity/expression listed in the harassment and opportunity posters that are posted. This seems to be the next logical step.
Below is Aetnas requirements for surgery. The foundation is there, I just do not understand in this day in age why it is not covered. The arguement seems to be that it is "cosmetic", but when I spend everyday of my waking life miserable because so much time has passed already and I do not forsee having the funds for another five years on my own, because life just keeps happening. WIthout surgery you have to take extra pills, putting you at more risk, you can't wear many things, (I have not been swimming in fifteen years). Not to mention the huge safety risk. It wears on you. Even something like checking an id at work can hamper your day. I would think the reduced medication, therapy, and doctor visit costs over the next 2-5 years would make up a lot of the difference. Could even require employment for a year.
Even it was a meet halfway deal, like I pay the surgery and they pay the hospital/anesthesia less deductible. Trying to be realistic too. Even though I seem to be the only transsexual in the company, out of 200,000+, I would guess there are at least five to ten others, so I cannot see costs expanding that much for these surgeries. I would not mind either if I had to have a higher tier/expensive plan. We have two now as it is, a third with more coverage would not be a big deal. 

Below is Aetnas policy and requirements, which I fit perfectly, as I am sure many others do. 

Clinical Policy Bulletin:
Gender Reassignment Surgery
Number: 0615


Policy

Note: Most Aetna plans exclude coverage of sex change surgery (gender reassignment surgery, transgender surgery) or any treatment of gender identity disorders.  Please check benefit plan descriptions. 
Aetna considers sex reassignment surgery medically necessary when all of the following criteria are met:
  1. Member is at least 18 years old; and
  2. Member has met criteria for the diagnosis of "true" transsexualism, including:
    • A sense of estrangement from one's own body, so that any evidence of one's own biological sex is regarded as repugnant; and
    • A stable transsexual orientation evidenced by a desire to be rid of one's genitals and to live in society as a member of the other sex for at least 2 years, that is, not limited to periods of stress; and
    • Absence of physical inter-sex of genetic abnormality; and
    • Does not gain sexual arousal from cross-dressing; and
    • Life-long sense of belonging to the opposite sex and of having been born into the wrong sex, often since childhood; and
    • Not due to another biological, chromosomal or associated psychiatric disorder, such as schizophrenia; and
    • Wishes to make his or her body as congruent as possible with the preferred sex through surgery and hormone treatment; and
  3. Member has completed a recognized program of transgender identity treatment as evidenced by all of the following:
    • A qualified mental health professional* who has been acquainted with the member for at least 18 months recommends sex reassignment surgery documented in the form of a written comprehensive evaluation; and
    • For genital surgical sex reassignment, a second concurring recommendation by another qualified mental health professional * must be documented in the form of a written expert opinion**; and
    • For genital surgical sex reassignment, member has undergone a urological examination for the purpose of identifying and perhaps treating abnormalities of the genitourinary tract, since genital surgical sex reassignment includes the invasion of, and the alteraton of, the genitourinary tract (urological examination is not required for persons not undergoing genital reassignment); and
    • Member has demonstrated an understanding of the proposed male-to-female or female-to-male sex reassignment surgery with its attendant costs, required lengths of hospitalization, likely complications, and post surgical rehabilitation requirements of the planned surgery; and
    • Psychotherapy is not an absolute requirement for surgery unless the mental health professional's initial assessment leads to a recommendation for psychotherapy that specifies the goals of treatment, estimates its frequency and duration throughout the real life experience (usually a minimum of 3 months); and
    • For genital surgical sex reassignment, the member has successfully lived and worked within the desired gender role full-time for at least 12 months (so-called real-life experience), without periods of returning to the original gender; and
    • For genital surgical sex reassignment, member has received at least 12 months of continuous hormonal sex reassignment therapy recommended by a mental health professional and carried out by an endocrinologist (which can be simultaneous with the real-life experience), unless medically contraindicated.
* At least one of the two clinical behavioral scientists making the favorable recommendation for surgical (genital) sex reassignment must possess a doctoral degree (e.g., Ph.D., Ed.D., D.Sc., D.S.W., Psy.D., or M.D.). Note: Evaluation of candidacy for sex reassignment surgery by a mental health professional is covered under the member’s medical benefit, unless the services of a mental health professional are necessary to evaluate and treat a mental health problem, in which case the mental health professional’s services are covered under the member’s behavioral health benefit. Please check benefit plan descriptions.
** Either two separate letters or one letter with two signatures is acceptable.
Medically necessary core surgical procedures for female to male persons include: mastectomy, hysterectomy, vaginectomy, salpingo-oophorectomy, metoidioplasty, phalloplasty, urethroplasty, scrotoplasty and placement of testicular prostheses, and erectile prostheses.
Medically necessary core surgical procedures for male to female persons include: penectomy, orchidectomy, vaginoplasty, clitoroplasty, and labiaplasty.
Note: Rhinoplasty, face-lifting, lip enhancement, facial bone reduction, blepharoplasty, breast augmentation, liposuction of the waist (body contouring), reduction thyroid chondroplasty, hair removal, voice modification surgery (laryngoplasty or shortening of the vocal cords), and skin resurfacing, which have been used in feminization, are considered cosmetic. Similarly, chin implants, nose implants, and lip reduction, which have been used to assist masculinization, are considered cosmetic.
Note on gender specific services for transgender persons:
Gender-specific services may be medically necessary for transgender persons appropriate to their anatomy. Examples include:
  1. Breast cancer screening may be medically necessary for female to male transgender persons who have not undergone a mastectomy;
  2. Prostate cancer screening may be medically necessary for male to female transgender individuals who have retained their prostate.

Background
Transsexualism is "a gender identity disorder in which the person manifests, with constant and persistent conviction, the desire to live as a member of the opposite sex and progressively take steps to live in the opposite sex role full-time."  People who wish to change their sex may be referred to as "Transsexuals" or as people suffering from "Gender Dysphoria" (meaning unhappiness with one's gender).
Transsexuals usually present to the medical profession with a diagnosis of transsexualism, a sophisticated understanding of their condition, and a desired course of treatment, that is, hormone therapy and sex-reassignment surgery.  The therapeutic approach to gender identity disorder consists of three parts: a real life experience in the desired role, hormones of the desired gender, and surgery to change the genitalia and other sex characteristics (Day, 2002). The most typical order, if all three elements are undertaken, is hormones followed by real life experience and, finally, surgery.
For male to female transsexuals selected for surgery, procedures may include genital reconstruction (vaginoplasty, penectomy, orchidectomy, clitoroplasty), breast augmentation and cosmetic surgery (facial reshaping, rhinoplasty, abdominoplasty, laryngeal shaving, vocal cord shortening, hair transplants) (Day, 2002). For female to male transsexuals, surgical procedures may include genital reconstruction (phalloplasty, genitoplasty, hysterectomy, bilateral oophorectomy), mastectomy, chest wall contouring and cosmetic surgery (Day, 1992).
Due to the far-reaching and irreversible results of hormonal and/or surgical transformational measures, a careful diagnosis and differential diagnosis is absolutely vital to the patient's best interest.  In and of themselves, a patient's self-diagnosis and the intensity of his desire for sex reassignment cannot be viewed as reliable indicators of transsexuality.  A vital part of the long-term diagnostic therapy is the so-called real-life experience, in which the patient lives as a member of the desired sex continually and in all social spheres in order to accumulate necessary experience.  Experience in specialist Gender Identity Units has shown that only about 15% of male transsexuals and 90% of female transsexuals are considered suitable for surgery or still desire it after specialist psychiatric care and a prolonged period of observation used to identify the relatively rare "true" transsexual from the more common "secondary" transsexual.
Hormone therapy and sex-reassignment surgery are superficial changes in comparison to the major psychological adjustments necessary in changing sex.  Treatment should concentrate on the psychological adjustment, with hormone therapy and sex-reassignment surgery being viewed as confirmatory procedures dependent on adequate psychological adjustment.  Psychiatric care may need to be continued for many years after sex-reassignment surgery.  The technical success of sex-reassignment surgery is greater for male-to-female transsexuals than female-to-male transsexuals, and continues to improve as new techniques are developed.  The overall success of treatment depends partly on the technical success of the surgery, but more crucially on the psychological adjustment of the transsexual, and the support from family, friends, employers and the medical profession.

Wednesday, August 8, 2012

The Day I Almost Died

I remember it like yesterday. As I find myself with some of the same feelings I did in the after math of that day, I reflect on what happend before so that it may not happen again.

May 15, 2006, I was 22. My judgment day, a day that has had lasting repercussions 
even to now. I was having a panic day at work. My girlfriend of the 
time, Sachia, ended it with me. Love of my life, over just like that. 
I lost it. Never did I want or feel a need to hurt her, but at the 
time an overwhelming feeling of hopelessness and despair washed over 
me. Yet somehow I maintained composure and a relative calm. 

I asked to stay a few minutes, collect my nerves to drive. Secretly I thought 
she was joking or unsure. As I watched 24 and glanced over at her the 
life and vibrancy in her eyes she had when seeing me was gone. I knew 
then it was over. Maintaining composure, I proceeded to the bathroom. 
In what is my lowest, most pathetic moment, I raided the medicine 
cabinet. I started taking everything. Excedrin, Tylenol, even 
menstrual cramp medication. I must have had at least 30 Tylenol, they 
had a huge bottle and it was candy. I went back a few times but that 
look sent me right in. 


Finally her dad asked me to leave. I tried 
giving her one last hug, but she stood there emotionless and cold. I 
went out to my car. I didn't make it inside. When I was taking the 
pills it wasn't so much that I wanted to commit suicide, but more a 
case of hurting myself bad enough to put me in the hospital and maybe 
she will forgive and come see me. How stupid and naive that was. That 
only made things worse. 

As I proceeded to my car, the feelings hit me 
like a Mack truck. I slammed my head hard as I could by my side 
window. The glass shattered and deeply dented a corner I hit. I 
stumbled back to the door, not asking for help, but asking to see 
Sachia again. Apparently in the shower, no doubt cleansing herself of 
me. Then I went to her room, and in a last ditch effort, tried to 
arrange some of our pictures and leave an apology. 


I went back to my car, got in, and slammed my head into the steering wheel numerous 
times. I must have done it till I passed out. I awoke several hours 
later in a pool of my own vomit and blood. It was everywhere, and what 
saved my life. Somehow I made it back home, despite being an emotional 
wreck. The rest is blurry. 

I know I tried going back over there the next day. I know I called Cingulars employee help line, and they told 
me to go to the hospital. I did. They did some tests and sent a social 
worker in. Sachia ignored their calls. Thank God for my friend Jennifer coming 
up there to check on me. In the aftermath of this, she helped me stay 
stable, and for that I will always be grateful. My only regret is that 
I didn't follow what Jennifer told me to do. Had I not pestered and nagged 
Sachia might still be on speaking terms. While I would give anything 
to be able to talk to her again, I must accept that ship has sailed. 

It's only now, years after it all happened, that I can freely talk about it without it bringing me 
to tears or threat of panic attack.

Monday, July 30, 2012

The Car Conundrum

Obviously I need a Car. Or do I?

After a series of unfortunate events, it has been a year since I have been without a car. Fortunately I was able to move closer to work just in time, so I can walk. Should have been easy right?

Well, the timing could not have been more wrong. They started construction on the road to work. Until a week ago there was not even a full sidewalk. They are widening it to four lanes and adding a sidewalk. Has been a nightmare ever since they started though.

Walking to work was awful. It was always muddy and dirty. I went through several pairs of shoes. Certainly didn't help the financial situation. Blisters and sores developed on my feet, and as soon as they start to heal after a day off they get worse again. Thought it would get better as it got warmer and I could wear flip flops.

To an extent it did, at least until April. My body heat is like a furnace. I quickly learned that unless it was under 50F°/10°C I would break into a sweat on the way to work. Now that it is well into the 100s it is unbearable. Just yesterday I found out that even with a good SPF 50+ UVA/UVB suncreen and Heliocare, I still got burn spots, even in places that were covered walking home today. Science says we were UV Index 10 on the scale, which may as well have been an Ozone hole far as I am concerned. I can't ever remember it being this bad. Then again, I spend more time in a cave than Batman.

Heliocare is not cheap. I hate to spend money on it but I have got to maintain my skin until after surgery at least. Try to look as young so I can feel as young as possible. I know I won't get to enjoy life until my 30s so trying to make them the best now. I find Heliocare works pretty well though, and as much as I have walked I have gotten a good tan without hardly a burn. Given the choice though I would rather stay inside and preserve myself. I hate the sun but as of now do not really have a choice if I want to work.

People have an exceptionally generous with rides. I am extremely grateful. If any of you are reading this I can't thank you enough.

I sure miss my Lancer. My favorite car. Unfortunately it got totaled. I was upside down in payments, and of course insurance was not enough to cover. They totaled it out and suddenly found myself owing several thousand. No car but still making $255 a month payments, and unable to get approved or refinanced on another. So began my car troubles. Gosh would I love to get another 2002 Mitsubishi Lancer again someday.


(my car at the beach, what a good day that was)

My credit was awesome back then. I got the car for $255 a month with no down payment. I could almost afford that now. Problem is, I would have to put my surgery off at least another year or two. With the way I feel now, I can't do that. Not for my own health. I have made it a year and I can make another. It will be hard but it will be impossible if I don't get my surgery going.

The good news is I recently applied for another loan. It was mostly for fun, but I was astonished at the results. Even though I filed bankruptcy in December of 2011, I got approved. Again no downpayment as above but a 14.99% rate. I have not look at cars but it does have me thinking. If only I could get a second job or a raise! Would make my life ten times easier. I could have both within a year.

Fortunately in some ways, the next year will be easier. They built an Uptown Grocery store right next to my work. This has been wonderful as I can get little things like Milk or Bread and sometimes even have a meal. They have a nice little buffet style deal for $6.00. I can have lunch there or buy a can of soup and eat it back at work. 

Not quite as nice as being able to go home and eat. I rented a car recently for a week. Mostly due to the high temperatures, and I could somewhat justify it on the weeks I work seven days in a row (once a month, every month). I did save a little eating at home. Bringing lunch to work has always been a struggle for me, I either don't bring enough and gorge on the vending machine, or bring too much and it goes bad or I forget about it. Also very hard to carry with my shoes and water to work.

As for a bike, I have tried that. All I have is my old butch mountain bike. Hard to ride and very uncomfortable. After trying it several times I have determined it easier to just walk. With the sidewalks though I am considering a road bike, the type with the skinny tires and such. That might work. Would at least shave ten minutes off my trip, thus freeing time for internet work/rest.

Lastly, I don't think anyone comprehends how hard it walking is for me. Walking is how my mom died. She had real bad schizophrenia and would have episodes where she would go walking, oblivious to her surroundings. She was struck by a car, knocked unconscious. The doctors declared her brain dead. My uncle explained everything to me. We decided to pull the plug. I was only 20. I was and still am devastated, and I think about my mom everyday I walk.

Even though I am in what is supposed to be the safe side of town, it really could not be further from the truth. Seems things happen at the park fairly often where the joggers go, which is across my work and on the same street I walk. Course people see me walking down the street, phone in hand and bag and I am sure I look like an easy target. What happens if someone tries to pick me up or worse and notices there is something different about me? The murder rate of transsexuals is 16 times higher than the national average.*

Ho hum, what to do. What to do.

Sunday, July 29, 2012

Why Don't I Get a Second Job?

Several people have asked me why I don't just get another job. Economy issues aside, it is not that simple.

First and foremost. My schedule. While I have figured out my rotation and know my days off, they are so random I can't think of any place that would want to work around them. Has not stopped me from trying but here is how it is.

Week 1: Wednesday/Thursday
Week 2: Monday/Tuesday
Week 3: Saturday/Sunday
Week 4: Monday/Friday

While the week is fairly consistent in what days are off, the times are a whole other matter. 1:30-10:30, 9-6, 8-5, 3-10, so random, These always change and are impossible to predict.

I have applied for several positions with better, set, more traditional schedules in the store but have yet to be even interviewed. That is a pandoras box I'd rather not touch again (I hit on it in a prior post)

Secondly, I have applied for other jobs at other places. AAA, Redbox, FAA, to name a few. Granted I waited awhile because I wanted to see how my current job played out. I do enjoy where I work.If I could find a 7-4, 8-5 whichever I would totally go part time and take that full time. Would solve a lot of problems.

Thirdly, damnit I am only one step away from making enough. Promotions tend to be 10% and that would put me well where I need to be to make headway without the internet.

Fourth, The internet. When it's good it's good. Unfortunately when it's bad it's bad. It is nice being able to do it when I want, how I want, no rules, wear what I want, poop when I want, sleep when I want, eat when I want. To equal the internet on an average day, I would need at least 20 hours a week @ $8 an hour.

Fifth, Food/Bills. If I could just stop eating so much. I spent over $400 in food in June. That should not be higher than $150. If I can cut stress I could lower my bills and save plenty more. Less stress would result in less of me sleeping it off, which would save on A/C costs since I crank it all the way when I sleep (keeps me out longer).

Side jobs - Certainly open to these, under the table things like painting, mowing, anything of the sort. Not good at finding these but would certainly love some and do them.

My Ever Lowering Standards

By my best estimates I am only $4,000 away from where I need to be. Wait only? Ha, may as well be 4 million. Internet work is at a low, and am I starting to hurt from the lost funds from missing real work. How can I be so close yet so far?

What scares me the most? A selfishness I have never known. An attitude that consumes my morals and ethics, threatening everything. I find myself on the cusp of begging. The shame of asking my friends for money, as if asking for rides wasn't bad enough. I thought I would get there through hard work and perseverence. 

Now that I see that is not happening, something within me has changed. What does it matter if I get myself into some questionable legal matters? I can handle those, as I have before. The gain outweighs the loss. I could get 4k by December. 

The worst part is, as I reach the final stages of my transformation, to get all the way there I find myself examining the ins to the adult industry. Certainly I help fill in a niche for certain undesirables of society, and to get to where I need to be, there are levels of survival I am prepared to accept. Could get to 4k by April.

I have nearly convinced myself I can live a year of awful sin, if it means I gain the rest of my life. Which brings me to Mark 8:36.

"What good is it for a man to gain the whole world, yet forfeit his soul?"

This question. I have wrestled with it for years. I am too smart for this. Too good. Nah life will work out fine I said. And I fell back. Stay strong and work hard I said. And I fell back. Stuck halfway there, no car, and hot temps. Noooo!!! The line must be drawn here! No further!


*disclaimer* This post in no way reflects my turning to the darkside. I still bask in the light. For now. Just a possible scenario if things don't improve quick. 

Saturday, July 28, 2012

The Date


So several people seem to be asking me this lately. When is the date? As in, when will I be having my gender confirming surgery?  F.Y.I. Please don’t ever ask someone bluntly “When is your sex change.”? It is incorrect and rude. Which I know from me sounds odd, but everyone has a line somewhere that must be drawn. When is your surgery or operation is a little better but I hope to answer that question.

In all honesty? Unsure, still need at least $4,000 (Thailand) or $18,000 (America). Been saving a while but life always seems to happen. Surely by 15. No. Fine whatever. 18…no 22? Yeah. Yeah! Yeah!!! No. 25 Absolutely! I am working two jobs. Will be easy. No. 28? How could I not? Still working two jobs, plus internet work! Wait second job come back! No. Shoot. Now what?

I will be lucky if it is before I am 30 at current rates. Best case would be February 2013, but that is assuming I get this grant next month, otherwise roughly summer 2013 at current rates. Or if I complete the time machine it would have been ten years ago. If only...

At 18 I had the money, the means, and the will. I had to try love though. Shayla, Jessica, Sachia. Damnit. This is where the timeline skewed into this awful unpredicted future. I made a choice. A choice that has had lasting repercussions to now and beyond. My 2015 won’t be filled with flying cars or hoverboards, but PTSD of a choice I made ten years ago. Hence the impossible imaginings of traveling back to that time and fixing what was broke. Granted the new timeline could be worse, but I don’t see how. I’ll save that for a future post.

Anyway. There is a side point to this. While the official surgery maybe away off still, keep in mind I have been on hormones since 22 (and for a month in 2003…03! Damnit). Which means at this point I am reaching diminishing returns. In other words, other than some longer hair and hopefully more head regrowth, plus some dress changes, you won’t see much difference. Especially if you have known me 10+ years. Hopefully can get my stress down and be more calm. With the delays in surgery, I have been and will be out as me beforehand.

A more concrete date will be posted upon scheduled surgery.

Friday, July 27, 2012

Another Low Point

The recent uptick in credit has put me in what should be the best situation since 2005. Yet I feel miserable. It has barely been three weeks since my friend and strong source of support went to tour Europe and I am not coping well at all. Hard to even watch the Olympics without thinking of her moving away to Texas when she gets back. Think I have been teary eyed all day.

Thus in reality, I find myself since June in a position worse than I was after Sachia. The wreckless attitude is back in force and I have lost care for most everything. Mostly stay in bed if not working with Benedryl induced sleep. Which makes things worse since I do not do internet work then. 

Tried a therapy appointment last week but came out feeling worse, they never last long enough and cost too much. She said that I had done well to get this far without no support. Unfortunately, that really put things into perspective. 

No one to talk to it seems anymore and I feel so alone. I had to rent a car just so I could see my dad since he can not seem to find time to see me ("oh I work ten hour days but my tailights out and I cant drive at night") yet when I went over there twice on two seperate days, he was free to sit at the bar with me for three hours and go to the casino. 

People say to be positive but really put yourself in my shoes? Imagine feeling so disgusted and so out of place with your own body that it makes you sick, you make just enough to pay your bills for your cramped apartment, can not have a pet, you have such a bad social akwardness you struggle to make new friends and you do not have the money to go back and finish school and you can not get aid because your defaulted loan, you have no car so you walk to work, rain, cold, hot, whatever through a muddy construction nightmare and you dont have the friends and family network most have. 

Imagine your moms dead, your dad does not seem to care, any other family that might have cared either doesnt care or is dead too, and the best advice your friends, if they are not too "busy", can muster is "man up", which always seems to be the ones who have had it relatively easy, such as a live, supportive mommy and daddy or have the social skills or shacked up with the right person.

You put your blood, sweat, and tears into work (which I can say for sure I do, between all the cuts, scars, blisters, aches, heat, and crying work does to me) yet despite doing the work of two people at work and doing everything your supposed to, and being more qualified and experienced then 99% of the people there, you get overlooked and blown off. 

Then you go home and start the cycle all over again day by day. That is no kind of life and nothing to be happy about. I feel like a slave to the passage of time, dragged through misery by an endlessly rotating Earth. At least the slaves had each other. 

Friday, July 20, 2012

On a Lighter Note..iPhone Games

Recently I have become addicted to those Endless Runner games on the iPhone. If you liked Temple Run then you should try these, there are some terrible knock offs, but the ones below are as good if not better than Temple Run. I think I like them so much because some of them remind me of Sonic the Hedgehog.

There are also flying ones which are really fun too, listed my favorites below. Best of all most of them are free! Though if you like them, support the developers with an IAP (in ad purchase).  Please, please, please check out Light the Night below! Sorry Android users most of these seem to be for iPhone with the exception of Temple Run Brave/Temple Run.

RUN!


Subway Surfers


My favorite. Has a wonderful color palette, much more rich and vibrant than Temple Run. Updated regularly and they have listened to fan feedback as well. Designed for both iPhone and iPad. Don't forget to watch videos for free coins!!!


http://itunes.apple.com/us/app/subway-surfers/id512939461?mt=8

TheEndApp

Found this one to be very fun, but they are big on an in app purchase (IAP) for the Pro Version. Not sure if that is worth it, but they did just add a lot of new for the Pro users. End of the world theme. Very colorful and fun watching the world degrade the more you play. Will give a Pro shot when I earn my next giftcard. Designed for both iPhone and iPad.




Temple Run Brave

It's Temple Run with a Disney Brave theme. They did add an archery mechanic while running, you have to tap targets to hit them with arrows. Adds some fun. Otherwise it is Temple Run (which is not a bad thing). I would try to catch it if it goes free, especially if you already own and have played the original Temple Run to death. Good on both iPhone, iPad, and Android. 99¢


http://itunes.apple.com/us/app/temple-run-brave/id524509185?mt=8

Also, here is a link to the original Temple Run. It is FREE! Android and iPhone/iPad

http://itunes.apple.com/us/app/temple-run/id420009108?mt=8

FLY!

Light the Night

My favorite iPhone game right now. Love, Love, Love the colors in this game. You play as a lightning bug, avoiding other bugs and flowers, trying to get as far as you can on your light fuel. Fun upgrades to different themed bugs too. Free, iPhone and iPad



Dragon Flight

Like a top down shooter. Fly as a dragon. The simplest of all the games but still fun, especially if your stuck in line at the grocery store. Free, iPhone and iPad


 http://itunes.apple.com/gb/app/dragon-flight/id530610467?mt=8

Jetpack Joyride

From the makers of Fruit Ninja. Has an extreme amount of polish and humor. Loads of fun and there is even a Facebook version. Great, original, and mix matchable powerups. Free, iPhone and iPad. It's three screenshots cool.



http://itunes.apple.com/us/app/jetpack-joyride/id457446957?mt=8

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*links above go directly to the Appstore, no commission received on the links above*