Psychological Effects Of FFS

When I had my facial feminization surgery (see also this article about it on autostraddle) with Facialteam in Mai, I was surprised that they not only had consent forms for the different procedures (that was to be expected), but also a „SPECIAL INFORMED CONSENT“ form for post-operative symptoms, that included a section for „EMOTIONAL IMPACT“, mentioning depression as a possible effect. They also advised psychological support for the post-operative phase (but I don’t find anymore where they wrote this).

Well, I thought that I am quite used to being depressed and to emotional turmoil, since it basically does come with the territory of tranistioning. Also I do have 20+ years of experience with psychotherapy so I expected this not to be an issue. And also, the main thing would be an improvement, finally being read as the correct gender, if anything, this should trigger euphoria and relief from stress, not depression or anxiety.

However, this might have been the first time in my life that I felt depressed for a while in the way that I here it from others with a diagnosed depression. I have been diagnosed with depression before, but especially in hindsight, I was just feeling bad because of a difficult life situation or because of not having transitioned, or in any case, I kind of knew what was going on. But I never had this feeling of not wanting to be among people or just feeling bad and dull without a reason. So that came with surprise. So here are some of the things that have happened:

  • I was very tired
  • I felt disconnected with people and didn’t want to go out
  • Sometimes I felt an unexplainable sadness
  • I was constantly tired, and sleeping didn’t help
  • I felt very self-conscious (also in the sense of „bad“) about my body
  • I felt fragile
  • I was shocked at sometimes still begin misgendered and at the fact that „female“ clothes still often don’t fit me
  • I am still very tired
  • But of course there were feelings of euphoria, of relief, and of finally being able to live my live.

For others who might have FFS and might experience similar effects, I will list potential dynamics that might contribute to these experiences. For me, FFS made the difference between being seen as a (male) freak and being seen as a woman. So, if you are in a similar situation, these thoughts might be applicable to you.

Anesthesia can take a long time to leave the body

This is already mentioned in Facialteam’s consent form. The drugs for the anesthesia can cause depression and can stay in the body for quite a while. It might still be a surprise because you do feel quite ok, already a few days after surgery, but this can still happen.

You just are more fragile

Faciateam mentions this as well, you just had „extensive, invasive“ surgery, so your body is occupied with fixing everything that has been moved around and will probably also tell your subconscious that this is happening. Also there are these little issues that come up (like a swelling appearing or not going down) that keep you bothering the patient coordinators 🙂 and give you a feeling of fragility – even though they keep on telling you that everything is normal and not to worry.

Also the fact that you have just made the experience that something that is so much belonging to the core of your body and your body image, like your face, is subject to change and has been „messed around with“ (in a very professional way 🙂 ) can make you feel very fragile, independent of how much destabilized your body actually is.

The exam is over

I don’t know if you know the feeling after you have just written a difficult exam that you were studying a lot for. Your life was filled with thoughts about the exam and with preparing for it. I think FFS (and probably also other transition related surgeries) is similar. It takes a while to come to the decision, and maybe also to save up for it and then to organize everything, and then the surgery and the first phase of healing and then – bam – what to do? A lot of what your mind was occupied with doesn’t matter anymore, it is over, you have done it.

That can get tiring and depressing suddenly you have to fill your life with other things again. And in the beginning, with all the swelling, you don’t see the full effects of the surgery, so that might be disappointing as well, or at least there won’t be the euphoria that could replace the new emptiness.

The stress is over

Similar, but later on, when the results are clearly visible, there is the effect (probably not for everyone, but it was for me), that you are not seen as a „man in a dress“ anymore. Even in the case that you don’t pass completely (your voice didn’t change, for example), it still means that most of the time people are not confused by you anymore, they don’t „send out“ irritation (by non-verbal (for example staring) or even verbal communication) anymore, you are just another woman that they might notice (or not) and continue minding their own business.

It took me a while to realize this and much longer to believe that this is actually the case and that it is reliable, but then it was an enormous relief. I can dress how I want to and basically nobody cares, I don’t have to put on androgynous clothing if I want a day without being stared at and I can go a public bathroom (restroom, toilet) without worries.

This reduced my everyday stress enormously. So why did it still make me tired? I think, step by step, all this tension that I had to keep up for several years, just to handle these irritated reactions, fell off. And of course keeping up this tension took a lot of energy, and now with it not being necessary anymore, my mind wants to recover from it and just use this liberty to not have to be strong all the time to relax and recover. I think, that’s also where the flashes of inexplicable sadness came from, it was probably sadness from a while ago that I didn’t allow myself to feel because I felt the need to maintain my strength.

Wondering about „Passing“ changes

When Facial Feminization works, „Passing“ (the concept is worth its own article, but another time) is a lot easier, so how you might think about it will probably also change. The ideal situation is, that you don’t have to worry about it anymore at all, you just pass and do your thing and stop worrying about it. Of course this is a big relief and reduces stress a lot, but adjusting to this new situation might still take energy.

And then there is the thing, that situations where you still get misgendered, for whatever reason, can get very confusing and they have actually sent me down some emotional spiral a couple of times. I think what is worrying most is the uncertainty, at least I don’t know what triggered the misgendering and I need to figure it out completely anew and that takes work. And also when you feel really secure in your identity and in the fact that you are also recognized as such, a sudden misgendering can be really disturbing.

Also I had the weird effect that I didn’t worry about passing before FFS at all – basically because there was no point, I never did, I was basically constantly read as male, independent of how I presented. So I had a lot of stress from misgendering, but no stress about passing – I didn’t even try. So now, that I actually am gendered correctly at least part of the time, I basically have to worry about passing for the first time. All this talk I heard from other trans women about managing passing through presentation etc., that I could dismiss before as irrelevant for me suddenly does make some sense and I start thinking about these things.

Goodbye Transphobia, hello Sexism

So there is a lot less to worry about, I can dress as I like and have normal freedom of movement. Wait, normal by what standard? Well, obviously by the standard for women. Not that I believe in these standards anyway, but now you will be confronted with all the things cis women get confronted with. Of course, it is still up to you to decide what to do with all those social expectations, but now you will be subjected to them, and you haven’t had time since puberty to develop your way of dealing with them, you’ll have to learn it quick, or even the hard way.

This topic is enough for a whole article and I might write one one day, just like this guy has done it for the opposite direction, but here are some ideas:

  • It turns out that even as a „man in a dress“ I was sometimes taken more serious than as a woman. For example, once a waiter tried to convince me that a carrot soup was a silverbeet soup. And I had to slowly explain to him, that one is orange, and the other is green, because he was like „no, try it, it’s correct“. Never anything like that has happened to me when I was seen as male (and presenting exactly the same way).
  • Women don’t put up their defenses anymore, the distance they maintain between me and them, for example in public transport, is a lot smaller than it used to be or they are just really friendly in everyday contacts, for example in a shop. This is generally very nice, especially since I always had the weird feeling when noticing how a woman was being very careful towards me (like when walking home at night from the tram stop) because I would feel the same. So it is really nice that this feeling is gone. However, since I am also attracted to women it was confusing at first that women get so close to me or are so nice to me without it meaning anything – or maybe there actually were cases where it did mean something but I didn’t realize. I guess, this is something most lesbians have to work through, but for me it just happened after FFS.
  • It can also happen that men are starting to be very friendly to you and start flirting. It doesn’t happen to me a lot since I am not pretty by normative standards, but still there is a lot of over friendliness and patronizing from men going on, and it is something I have to find a way to deal with. And of course there is the really obnoxious stuff like catcalling. It might feel good once or twice, because it shows you that your gender is read correctly, but then it is just „fuck off!“.
  • Speaking of beauty standards. They suddenly matter to me. It is really weird, but before I could do what I want, I was always the freak, and how my body looked like didn’t really matter that much because I was outside the scale of how women can look like. Now I am perceived inside the scale and so I start worrying about the stuff many other women worry about, like weight, whether something I wear will look good on me, whether I show too much of my body etc. It’s nothing unusual, but it’s the first time I worry about it, because it now does make a difference whereas before I had something like a „jester’s license“.

Ok. That’s all the ideas I have right now. Comments are very welcome, especially if you have experienced some different or additional effects. As you can see, most of the effects are actually positive and what we want in the end (even the sexism, in the sense that we do want to be perceived as women. Then we can fight sexism from the fitting starting point 🙂 ), but in the meantime they can cause a lot of turmoil. I think especially the fact that people react differently now can make you very tired, because your whole mind needs to readjust the expectation it has of how people behave towards you and for what kind of reaction you need to be prepared. But it’s all good, it means, we finally arrive at the social position we wanted to arrive at, with all its good and its bad sides.

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9 Antworten zu Psychological Effects Of FFS

  1. Peter schreibt:

    Wenn du ein Mann warst, der auf Frauen stand, und nun zur Frau wurdest, die auf Frauen steht: Hättest du dir den Weg nicht eigentlich sparen können?

  2. Lilia schreibt:

    bitte Tina! what a wonderful blog!

  3. satanicpuritan schreibt:

    I’ve experienced very similar things. The passing thing definitely makes you question what other people are thinking when they encounter you.

    • tina201301 schreibt:

      Yep. People seem to be so friendly now sometimes. It’s really odd, I also might become a bit pretty by society’s standards (don’t know about that, but it would explain some things) or in any case people are not confused by me anymore so they are free to be personal with me. It’s really weird thinking that all this comes from some changes in my facial bone structure.

  4. Pingback: Kommentar zum AWMF-Leitlinien-Entwurf, Kapitel 4 | wunder2welt

  5. Pingback: Kommentar zum AWMF-Leitlinien-Entwurf, Kapitel 7 | wunder2welt

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