The Pain Inside

by Karen Page

The best planned transition is never over while unknown conditions lie in wait.

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The pain was getting worse. Much worse. I went to the toilet for the umpteenth time to relieve the pain. I couldn't stand it anymore, and made an appointment with my GP. This was going to be so embarrassing.

"So what can I do for you?" my GP asked the following morning.

"I'm in a lot of pain down below."

"Okay Amy, can you take of your skirt and knickers, and hop onto the bed."

I'd been insistent that I saw my standard GP as she knew I was a pre-op transsexual. However, it was still embarrassing that I had issues with my manhood. I did as she said and she came across.

"Sorry, I know you don't like looking down there, but I'm going to have to feel. Are you okay with that?"

I'd been hoping she'd just take a look and give me some antibiotics. I was starting to wish I'd never made the appointment. I'm sure it would have got better.

She eventually finished and when I finished getting dressed joined her back at her desk.

"Amy, do you do breast self checks?"

"Yes."

"How often?"

"About once a month."

"Good. How often do you self check your testis?"

"I don't."

"You should do them like you do your breasts. How long have you had the swelling and pain?"

"A few days, but I thought it was the tight panties, or that I wasn't pushing the testis up inside me properly."

"I'm sorry, but you probably should have come earlier. You have a lump, which doesn't allow a light through, so is some sort of mass. I'm going to make an appointment for you to see a specialist at the hospital."

"When?" I asked, in shocked.

"If you wait in reception, I will see what I can do."

I was almost a zombie as I went to the waiting room. Did I have Cancer? Was I going to die? I didn't want to die, not now. I couldn't die until I was fully me. I couldn't die with this manhood still between my legs. It had always felt wrong, and it was probably killing me.

"Amy? Amy?"

I looked up, and looked at the receptionist through bleary eyes. "Yes," I uttered.

"Doctor Singh is ready to see you."

I went back in. "You've got an appointment to see a consultant in two days. This letter has all the details in. I hope you don't mind, but I rang Chloe to come and pick you up. I don't think you are fit to drive."

"Thanks," I mumbled. I couldn't believe I'd got an appointment in two days. Normally appointments at the hospital took weeks, if not months. Two days? I really hope I'm not going to die.

* * *

Chloe was a godsend. She'd stood by me when I revealed that I was transgendered and hadn't left my side since she'd got to the doctors to pick me up. She was the one who phoned the office and told them I was ill. Now she was with me at the hospital, waiting next to me for an ultrasound.

"Amy Tomlinson," a nurse called.

"Come with me," I demanded, grabbing Chloe's hand and dragging her up.

"I was," she responded, following me into the room indicated by the nurse. Once we were inside, the nurse closed the door.

"Which one of you is Amy?" the radiographer asked.

"I am," I said, raising my hand slightly.

"Okay, but I think we have some sort of mistake. I have been asked to perform a genital scan for testicular cancer. I checked with the consultant, who said it was correct."

"I'm a pre-op transsexual," I sighed. I hated people knowing.

"I see. I know this is going to be very embarrassing, but I'm going to need you to take of your skirt and panties."

I did as asked, and Chloe took them from me, as I lay down and braced myself. Chloe must have seen how tense I was, and came across and held my hand. I tried to see the pictures that were on the screen, but they kept changing and the image meant very little to me.

"Okay, all done. Here are some tissues for you to remove the excess gel."

I cleaned up and quickly dressed. It could have been a lot more embarrassing than it was. The technician just got on with the scans and it seemed to make no odds that I was transgendered.

I turned to ask the results, but the operator had disappeared through a side door, and it was just the nurse.

"Do you know the results?" I asked.

"Sorry, no. The radiographer has gone to do another scan in a different room. I believe you've got an out-patient appointment later with a consultant."

"Yes."

"Okay, the results are sent electronically, so should be there for your appointment."

"Come on love," said Chloe. "Let's go and get a cuppa, while we wait for your next appointment."

I felt gutted that I'd had an early warning of the results. Was it a sign that the results were bad and they didn't want to give me the bad news?

The WRVS* café sold the traditional drinks, cakes and sandwiches. I didn't really feel like anything, but took the cup of tea that Chloe passed to me. I didn't know what to say, and it seemed that Chloe didn't either. We had our drinks in silence, and I worried about what the consultant would say.

"I'm Amy Tomlinson," I said announcing myself at the outpatient reception. "I have an eleven o'clock appointment with Dr Dougall."

The receptionist was a bit puzzled, but checked her list. "Oh, so you do. If you take a seat in area C."

We wandered down the corridor and eventually found area C. Not surprisingly, it was full of men, either on their own, or with their partner. I got some strange looks when we joined them.

The man who was sitting next to me eventually leaned across. "I think you are in the wrong waiting area."

"I wish I was," I responded.

It was a painful wait. Some that went in came out with obvious relief on their faces. Others came out in floods of tears. I tried to guess which would be which, but always seemed to be wrong. I jumped a bit when I was called. It was like the whole room looked up, when it was confirmed that I was supposed to be there. I'd been half worried that they was going to use my male name, just to fit in, but that had long since been assigned to the archives.

I held my head high and walked slowly to the consulting room, with Chloe holding my hand. Sod what they think.

"Please have a seat," said Dr Dougall. "Which one of you is Amy?"

I indicated that I was, and took the seat closest to him. I'm not sure if Chloe got upset that people wondered if she could be a male to female transsexual or if she was pleased that she'd done a good job in helping me when I'd told her.

"The ultrasound has confirmed what your GP suspected, you have a growth attached to your left testicle. We would normally do a blood test to get a secondary confirmation, but due to you being on HRT, that would screw up the results."

"So what now?" Chloe asked. I just sat there, wondering if this would have happened if I'd been able to have my sex-change before now.

"We will remove the testicle, so the cancer doesn't spread. This is a rather straight forward operation."

"An orchiectomy," I muttered.

"Yes, I suppose you would know those type of terms. After that, we would like you to have a single session of chemotherapy. The ultrasound didn't show any spread of the cancer, but we like to be sure."

"Couldn't you just give me a vaginoplasty instead?" I asked hopefully.

"I'm sorry, but that is beyond the skills of this hospital. However, it would be a sure way to know you wouldn't get a relapse in that area. Are you on the waiting list at a UK clinic or abroad?"

"Charing Cross."

"Excellent. I tell you what I'll do. I'm going to write to your surgeon and ask if your surgical date can be brought forward."

I burst into tears. "Thank you," I attempted, but I don't think it came out right.

"I think that was a thank you," said Chloe.

"So do I," laughed Dr Dougall. "Now I've just got the bed manager the tricky situation of sorting you out a bed."

"A bed?" I asked, after pulling myself together.

"Yes, you will be in hospital a few days after your operation. The ward normally only has male patients. I don't think it would be very nice for you to have to be there."

"No." I agreed.

"The ward did have a side room, but it is not currently in use. I'm sure it will soon be back for you. Would you please come into the hospital tomorrow in the late afternoon. I will then operate on you the following morning. You will then spend two further nights in hospital while you recover. We then can talk about your chemo after that."

"Tomorrow?" I asked, very surprised.

"The government have provided a lot extra resource into cancer treatment. I would like to do yours quicker, since we don't have all the information we usually have."

I walked out of the door, not crying, not sad, but glad a way forward was planned. It wasn't until I was in the car that I realised I'd not discussed success rates. However, with talk about not appearing to have spread certainly perked me up.

The hospital stay wasn't nice, and nor was the pain, but I'm told this was nothing compared to the pain I might feel after GRS. The nurses were excellent, and treated me like an honoured guest. I guess they didn't get many women having this type of procedure. After the drains and catheter were removed Mr Dougall came to see me.

"Before the surgery, I spoke with your prospective vaginoplasty surgeon. He advised putting in a prosthesis to replace the removed testicle. This will keep you from losing too much tissue, which will be needed for your vaginoplasty. As to your surgery date, he agreed to move it forward, but cautioned that you need to be over your chemo first. Your body will have enough trauma to deal with following that operation and he doesn't want the complication of it just getting over your chemo."

That made sense, but I was slightly disappointed that it wasn't next week. However, it was better than waiting another six months.

Epilogue

Following my cycle of chemotherapy I went back and had another ultrasound. I was given the all clear. I felt lucky that it had been caught quickly and that the system had been enhanced so the cancer was removed promptly. I was so grateful to the professionals involved, as nobody kicked up a fuss that I was a female with testicular cancer. They got on with their job of making me better, and for that I was so thankful.

Throughout the entire trauma, Chloe had been with me the whole time. Her work had been just as flexible as mine had. On hearing that I'd got cancer, her company promptly put her on paid leave and told her to be with me.

Since my GRS, testicular cancer is now something I can't get, but both Chloe and I had added a UK cancer charity to our monthly outgoings. Wouldn't it be nice, if others didn't have to go through what I did?

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* WRVS = Women's Royal Volunteer Service.