This image was removed due to legal reasons.

I walked into the operating room on a sunny Tuesday morning, feeling slightly punch-drunk already, clinging to the hand of a nurse because, with my glasses off, I couldn’t see a thing. The room was a bright blur of light as he nudged me gently up onto the step that led to the operating table. I felt something cold and slippery go into my IV just as the surgeon walked into the room. Then I was in recovery, shaking uncontrollably while the nurse draped me in warm blankets.


I had just gotten a subtotal mastectomy—better known as top surgery, a procedure that many think of as a milestone in FTM transitions. For me, it was also a major step past the between-space I had occupied for months, as my body slowly went through a second puberty, testosterone trickling through my system and creating a growing sense of cognitive dissonance not just for myself, but for the people around me. People with breasts and beards, deeper voices and wide hips, are…unusual. And this between-space is as much a deeply awkward rite of passage for many trans people as getting a boner in class is for teenage boys.

The same day I woke up with my chest covered in bandages so thick it felt like nothing had changed, the residents of Houston were voting down a civil rights ordinance that, among other things, gave people like me the right to pee in public bathrooms. Recovering at home several days later, I read a noxious op-ed in the Guardian suggesting people like me are just being “trendy.” What Time has called the “transgender tipping point” I think of as a more aggressive public visibility for trans people—sometimes for the better, sometimes much worse.


And with visibility comes a very physical kind of scrutiny. Earlier this year, Caitlyn Jenner decisively came out as trans, showcasing her figure on the cover of Vanity Fair and putting an end to months of speculation about her shifting appearance. She, like many trans people, transitioned in public, going through immense psychological and physical changes while everyone stared at her and mocked her for looking strange, before objectifying her as “hot” after the grand reveal. Jenner didn’t have the opportunity to take a few months off and return transformed; instead, we all watched her change like a sculpture in a house of mirrors.

This image was removed due to legal reasons.

In May, I began testosterone therapy, commonly thought of as a masculinizing hormone treatment, though I am not, strictly speaking, a man. I identify as genderqueer, and I wanted to change the distribution of fat and muscle on my body, deepen my voice, and alter my facial structure so people would stop continually misgendering me. So I could stop avoiding myself in mirrors and compressing myself in social settings to make my hated body smaller. My body was my albatross, and testosterone was the sailor that would untie the cord around my neck.

The onset of puberty is a universal human experience. You remember that moment you find blood in your underwear, or when you suddenly realize that boys around you are proudly cultivating thready beards on their previously smooth faces. For some of us, these times were warning signs—this state of transition felt less like growing into adulthood and more like a bodily betrayal. When I began taking testosterone, it was like a hormonal do-over, a second chance at life as someone else, removing the costume of “girl” I’d been wearing for years and becoming more myself.


At the same time, it plunged me into a surreal state of upheaval all over again, except that instead of slowly sprouting breasts, I was peering at my flowering mustache in the mirror, caught in a facial hair crisis. Would I look like a douche if I grew it out? Should I wait to find out? Since I still had my breasts, should I shave it off anyway to avoid transphobic commentary?

I pinged a friend on gchat, the universal millennial emergency broadcast system, to ask for shaving advice, and he threw me into a rabbit hole of browser windows and a long discussion on straight razors. I sifted through my closet, coming up with a giant bag of clothing to donate or sell—everything chosen for its willingness to accommodate huge breasts. My pants began sagging and loosening as my hips lost weight, even as that weight helpfully transferred itself to my midsection. People who didn’t know I was on T could tell that something was off, but they didn’t know what—and I was frozen when it came to talking about it. You don’t want to tell every cis person you meet that you’re going through puberty when you’re 30.


In San Francisco, where I spend half my time and people in a state of gender flux are not uncommon, I attracted nods of recognition and solidarity. Not so in my small town in rural Northern California, where neighbors who once recognized me were unsettled by my shifting appearance. I had to step cautiously to avoid transphobia, to pass as a woman until the last possible moment. That meant shaving, blaming my voice on a summer cold, wearing elaborate ‘50s frocks to signal aggressive femininity in the hopes of distracting people, or just avoiding being out in public altogether. You can’t judge what you don’t see.

That day on the operating table, that last possible moment had come.

A t my follow-up appointment a week later, the physician assistant held up a mirror to my bruised and bloodied chest. After years of feeling physically and emotionally bogged down by my breasts, I felt oddly unsupported and naked. I moved with caution to avoid pulling at my sutures, finally seeing the musculature that had been developing thanks to T even without conscious effort on my part.


On my first trip to the local grocery store, still feeling unstable and sore, I ducked people I knew, not ready to have the first of many complicated conversations. I had gone through a process we associate with becoming an adult, but it didn’t exactly feel like growing up. Instead, I had gone backwards in time, to the split in life where the difference between “boy” and “girl” suddenly seems to matter.

I feared that taking testosterone would result in the same whipsaw of feelings that rocketed through me in my teen years, when estrogen changed my emotions just like it changed my body. At the time, a firestorm of gender anxiety seemed to dictate everything I did, my experiences dismissively written off as “teenage hormones.” Everyone around me warned that my moods would change on testosterone, too, that it would make me short-tempered and aggressive.


But unexpectedly, a strange calm settled over me. I grew more centered, more sensitive to the needs of others. It might take as much as two years for my body to “settle” on testosterone, and the same holds true for my chest—estimates not dissimilar to puberty. This time, though, those changes, my between-space, are welcome instead of dreaded. People asked why I seemed happier, and the answer was hard for me to believe, too, lying as it did in a row of glass vials and needles in my medicine cabinet. Transition is no longer abstract; there's physical evidence, and even in the middle of it, I finally know who I am.

When I got home from the hospital, I threw out my bras, listening to the satisfying tink of underwire on trash can. People ask me how I’m doing, wonder if I’m in pain.


“I’m great,” I say, with a smile.

s.e. smith is a writer, editor, and agitator focused on intersectional social justice and based in Northern California. smith's international publication credits include the Guardian, the Sydney Morning Herald, Rolling Stone, Bitch Magazine, and Reproductive Health Reality Check.