FFS

There are a couple types of FFS surgeons.  Basic makeover surgeons and technical FFS Surgeons.

FFS stands for facial feminization surgery or the feminizing of a male face by using surgical means.

Many surgeons will claim to be "Board-Certified in Plastic Surgery".  They can claim this and that and promise you the world and sell you on a surgery.  This is not a bad thing nor is it a good thing.  It merely depends on the needs of the patient.

If you have a very masculine forehead and pronounced brow bone and male chin, jawline, big nose and will need extensive work and reconstruction...you do not want to go to your run of the mill local board-certified plastic surgeon. Why?  They can't do the extremely technical and invasive procedures necessary to make your face feminized and passable.  You'll be throwing money away.  You'll spend $10,000 and then after the surgery, you'll be unhappy with the results and you'll go spend another $25,000 - $35,000 to pay someone to try and fix it.

This is YOUR face for the rest of your life.  You want to be sure that YOU are going to be happy
with it.

For those types of procedures there's maybe 7-10 surgeons in the entire world TOPS who can do aggressive facial feminization work.

Type 3 Forehead Reconstruction FFS Surgeons

Jordan Deschamps-Braly
San Francisco, CA

Dr. Deschamps-Braly is the understudy of Dr. Douglas Ousterhout, who is the godfather of FFS and he recently retired.

Dr. Marcelo Di Maggio
Buenes Aires, Argentina

Dr. Jeffrey Spiegel
Chestnut Hill, MA

FacialTeam in Spain
Marbella, Spain

Dr. Parag Telang
Mumbai, India

Dr. Eric Bensimon
Montreal, Canada

Dr. Lazaro Cardenas

Guadalajara, Mexico

Dr. Suporn
Thailand

Dr. Chettawut
Bankok, Thailand

Dr. Bart Van de Ven
Antwerpen, Belgium

Dr. Harrison Lee
Beverly Hills, CA
New York City, NY

DR. M.F. NOORMAN VAN DER DUSSEN

Belgium

Dr. Barry Eppley
Carmel, IN


(Note: Currently there are NO surgeons capable of doing type 3 forehead reconstruction surgeons in the state of Colorado).

These surgeons do what is called a Type 3 forehead reconstructive surgery.  It is serious craniofacial and suborbital surgery. Major reconstructive of forehead, brow and eye sockets. Not every transgender woman will need this type of work, but many will.

Susan's Place has an excellent thread on the types of surgeries and the differences in the male and female skulls.
https://www.susans.org/forums/index.php/topic,202486.0.html

http://www.virtualffs.co.uk/Forehead.html


Dr. Deschamps-Braly's website discusses exactly what craniofacial surgery is and consists of.
http://deschamps-braly.com/craniofacial-surgeon-san-francisco/


If you pass very well, you already have soft features, a naturally feminized face and you need a few subtle minor changes such as a little smoothing, some rounding, raising the eye lids, raise the eyebrows and some other light cosmetic surgeries then a board-certified plastic surgeon will do you just fine and there is no need to go find a surgeon capable of type 3 forehead reconstruction.

Denver has two board-certified plastic surgeons that can handle these types of surgeries.

Type 1 Facial Feminization Surgeons (here in Colorado)

Dr. Terrance Murphy
799 E. Hampden Ave.
Suite 540
Englewood, CO 80113
Phone: (303) 788-8400
info@murphyplasticsurgery.com
http://murphyplasticsurgery.com/

Dr. Andrew Wolfe
Golden Complex
725 Heritage Rd #100
Golden, CO 80401

Cherry Creek Facility
501 S Cherry St #900
Denver, CO 80246
Phone: (720) 279-1926
https://www.thecenterforcosmeticsurgery.net/cosmetic-surgeon-wolfe.cfm


There is a type 2 forehead reconstruction surgery as well.  All three types are explained here.
http://www.noormanvanderdussen.com/feminization/forehead-recontouring.html


No one can tell you who the right surgeon is for you.  You have the links and the information above, it is up to you to decide what it is exactly that you need, do several consultations, look at their before and after results, ask questions, do research and figure out what questions you should be asking during your consultations to figure out everything and then you choose the best possibly surgeon for YOUR NEEDS.  All surgeons will have pro's, cons, positive reviews and negative reviews and complaints. It's like buying a car.

This is a pretty good read on the different types of FFS surgeons, how to evaluate their qualifications and abilities and make a sound decision.
http://facialfeminization.surgery/index.php/ffs-history/


This quote comes from a person who had FFS with the wrong surgeon, spent a bunch of money and then had to turn around and spend a bunch more to get it fixed.

"Oh my, where to start with this...

How about the basics?

Your face is the SINGLE MOST VISIBLE PART OF YOUR ENTIRE BODY.  Within a fraction of a second, it's possible for people to determine whether to gender you as male or female just by looking in the area close to your eyes.  Your face will NEVER BE HIDDEN in the same simple way that we can hide other aspects of our bodies or personalities.  Genitals and other parts of our bodies can be hidden under clothes.  Our voices and mannerisms can be altered.  We can hide baldness under wigs.  But none of that matters if WITHIN A FRACTION OF A SECOND SOMEONE HAS ALREADY DECIDED THAT YOU'RE MALE BASED UPON YOUR FACE.

It follows that the face is the most important area of many MTF transitions where accepting anything other than the best surgical results possible is utterly foolish.
Consider my case: I initially went to a local board-certified plastic surgeon for my FFS.  I thought that staying in my home city would make life easier, and I found someone who claimed to have done trans work before and who managed to convince me of his skills during a couple of consultations.  The price was good - about half of what FFS would normally cost - and extra savings were to be had by avoiding travel, time away from home etc.  What's not to like?

In fact, the guy I chose was almost identical in background to Dr Murphy.
Woke up from surgery and was instantly disappointed.  The hairline advance was clumsy.  The brow lift was good, but because the surgeon wasn't able to perform a "type 3" procedure and only did a "type 1", my brows looked stupidly high compared to the prominent brow bone that was still there.  My nose was lovely - he did a great job with that.  And we didn't even touch my lower face, which he thought was feminine enough already.  Be careful about listening to plastic surgeons.  They're very, very, very good at (1) making you feel slightly bad about the way you look, and (2) telling you their services are the best way to fix it.  Salespeople through and through.

My brow ridge was still obvious.  My eyes were still deep-set and very masculine.  But I convinced myself that it was a good result, and told everybody that I was happy with the outcome.  In reality, it was a thorough disappointment and I felt deep down like I'd wasted my time and money.  Within two months of surgery, I was already getting in contact with the actual FFS surgeons in the US to arrange consults to fix what had been done.

And a year later, I had surgery with one of the big name FFS surgeons who could actually do a "type 3" forehead reconstruction, along with correcting/enhancing some of the stuff that the first surgeon didn't do well or didn't do at all.  Lower face, for example.  Lots of bone work that the local board-certified surgeon told me didn't need to be done (probably because he couldn't do it).  Am I pleased with the result?  Yes, most definitely.  Now that I've had a proper "type 3", along with significant reshaping of my orbital rims to get rid of the deep-set look in my eyes, and along with lower face work, I look far more feminine than before.  Removing deep-set eyes requires invasive forehead bone work, not just soft tissue stuff like a brow lift and eyelid work (which most certainly won't solve the problem).  And this is the kind of work that the average plastic surgeon who works on stay-at-home moms (who already look female) just never encounters in his or her surgical career.  FFS is not the work of a generalist.  You need a specialist.

My costs?  The first surgery was about $10,000.  (This was a while ago.)  The corrective real FFS was about $25,000.  So a total spend of about $35,000, including travel and related expenses for the second FFS.  Had I gone to the proper FFS surgeon initially, I'd have spent about $30,000 because my nose had already been done and didn't need correcting the second time.  So a slight extra expense, but two face surgeries SUCKED, as did the year of utter misery while I resented my stupidity for ignoring the common-sense advice of almost everybody in the trans community.

The choice of surgeon is CRITICAL.  A generalist like Dr Murphy can't possibly be experienced and trained in FFS techniques, at least not to the level that the actual FFS surgeons in the US are.  Look at his website.  He spends his days doing mommy makeovers, boobs, liposuction, and mini facelifts.  At a guess, I'd say he does a trans patient maybe once every couple of months - at most - and even then he's not doing actual FFS, but rather applying general, simple, and ineffective soft-tissue procedures to transwomen's faces.  A dedicated FFS surgeon will have done hundreds, if not thousands, of transgender patients, many of which will include significant bone reconstruction.

A typical board certified plastic surgeon making a living from stay-at-home moms WILL NOT DELIVER RESULTS comparable to the likes of Spiegel, Zukowski, Deschamps-Braly, Lee, or FT.

Ok, let me temper that a little.  If all you need is a nose tweak or a brow lift, then yes, a standard board-certified plastic surgeon will probably be good enough.  But if, like the OP in this thread, the issue is BROW BONE and/or JAW BONE, it would be a complete waste of time and money to go to a surgeon who is incapable of performing those procedures!

Take a look at Dr Murphy's results on his website.  They're really not very good at all.  You can clearly see that at best, all he's been able to do are very minor alterations.  The underlying bone structure - particularly the foreheads - are identical in the before's and after's.  His work has had, at most, a rejuvenating effect.  The feminizing effect of his work is non-existent.  This is the same result that I had when I went to a normal plastic surgeon first.  I looked slightly different, but zero percent more feminine than before.  And this is facial FEMINIZATION surgery.  The goal is to look more feminine, and Dr Murphy (and probably almost every other non-FFS surgeon) just can't perform the underlying work necessary to make people look more feminine.  They don't know what they're doing.  In fact, the only feminization I see in Dr Murphy's before's and after's is that he's used the trick of taking before's with no makeup or wigs, and after's with makeup and wigs.  It's as if he hasn't operated on the patients whatsoever, other than raising one woman's eyebrows to a slightly unnatural position.  From an objective standpoint, these results are very poor!  Subjectively, I'd say they're pathetic.

So with FFS, you get what you pay for.  To get good results costs money, it takes time, and it takes the effort of going to where the good surgeons are.  It's a very specialized field, and while the usual arrogance of plastic surgeons might cause them to all claim they can perform FFS, in reality there's only a handful of surgeons worldwide who can actually deliver on their promises on a consistent basis.  Driving distance should NEVER be a factor.  Every city in the US has board-certified plastic surgeons who will claim that they can feminize your face.  The fact that Dr Murphy is seven miles away from where the OP lives shouldn't even enter into the equation.  FFS, like SRS, is probably going to involve almost a couple of weeks away from home and a trip on a plane.  Based upon his results and based upon my own experiences with a very similar surgeon, I'd say that every dollar spent on Dr Murphy will be wasted.

Why did this thread cause me to re-register and dive into what will undoubtedly become a bit of an argument?  Because the suffering that my useless first FFS caused still stings to this day, and I strongly believe that it was unnecessary and caused in part by my own misguided belief that board-certified meant "good enough" and that staying local was important.  And the OP's thought process is frighteningly like my own.  It's an expensive mistake waiting to happen.  And it's well known that there's very few people who are willing to speak ill of their surgeons and admit that they had poor results, so it's no surprise that his patients in Denver are all saying that they love his work.  If I was a patient in one of his before's and after's, I'd be banging on his office door asking for a full refund!

I'm deliberately not mentioning who my first FFS surgeon was, nor who I went to after that to have it all done properly.  I'm not promoting any particular surgeons, and won't divulge this information.  It's not important to the message in this post, which is to take FFS extremely seriously, to realize that it's very specialized and complicated surgery that only a few surgeons can perform competently, and that the face is the number one most important aspect of getting gendered correctly.

Want to avoid getting whispered about in doctor's waiting rooms?  Get proper FFS, not some budget version by a local doc who talks a good game but clearly won't fix the problem."

NOTE: The opinions in the quoted section directly above do not necessarily reflect the views, opinions or beliefs of the author of this blog.  This quote was posted to show the seriousness and criticalness of selecting the proper FFS surgeon.  The views on Dr. Murphy are the author of the quote's and strictly their own.

Furthermore, the author of this blog has no opinion on Dr. Murphy himself as the author of this blog has never received treatment from him and does not wish to engage in any commentary that could be considered slanderous or libelous terminology or be engaged in any defamation of Dr. Murphy's character or business practice.  The only statement the author makes in regards to Dr. Murphy's abilities is that Dr. Murphy DOES NOT do Type 3 Forehead Construction which is a FACT.

Speech Therapy

This is a set of documents I obtained from the Veterans Administration Health System while I was in transition.  I did Speech Therapy through their Speech and Audiology Department.

You can download the .pdf file here.
https://www.dropbox.com/s/kqk0i4d4d3lcnk4/VoiceTherapy.pdf?dl=0


You can also purchase Calpernia Adams' Finding Your Female Voice Speech Therapy Program.  It has a .pdf and a disc of audio files.  She gets good results with this audio disc.  The link to buy the disc in the pdf file below.

http://www.genderlife.com/wp-content/uploads/2010/04/voicebook020.pdf

There's a few computer programs that will help you measure the pitch, resonance and db level of your voice.


Praat for MAC
http://www.fon.hum.uva.nl/praat/download_mac.html

Praat for Windows
http://www.fon.hum.uva.nl/praat/download_win.html

Here's a link that tells you how to use the program effectively.
https://www.susans.org/forums/index.php/topic,150142.0.html

Note Frequency Table
https://www.seventhstring.com/resources/notefrequencies.html

http://sail.usc.edu/~lgoldste/General_Phonetics/Week10/Formant_Analysis/index.html


You can use PitchLab to check the pitch of your voice on your mobile phone
https://play.google.com/store/apps/details?id=com.symbolic.pitchlab&hl=en

https://appsto.re/us/aNMRR.i


Speech therapy has limitations, but it will help teach you to feminize your voice to an extent. However, once you stop seeing gains, that's it; you're maxed out on any further progress.  If it is acceptable to you, then you will need nothing further.

If it is not acceptable, you will need surgery to have your vocal chords altered to produce a feminine pitch.

There are many known surgeons that can do vocal chord surgeries, but I'll list the most prevalent three.

Dr. James P. Thomas, MD.
909 NW 18th Ave
Portland, OR 97209-2324
thomas@voicedoctor.net
http://www.voicedoctor.net
503-478-1845
866-766-1994


Dr. Toby Mayer, MD.
416 Bedford Dr, Suite 200
Beverly Hills, CA 90210
info@bevhills.com
http://www.bevhills.com
310-278-8823
800-854-8823


Dr. Michael C. Haben, MD
980 Westfall Road
Building 100, Suite 127
Rochester, NY 14618
http://www.professionalvoice.org
585-730-8151

Surgeons

There's a great deal of surgeons to choose from when it comes to picking someone to perform your surgeries for Female Facial Feminization, gender reassignment surgery, Adam's apple shave, vocal chord width reduction, body shaping, breast augmentation, dual breast mastectomy, phalloplasty and other procedures.

What is the right choice?  How do I make that choice?

Well I can't specifically tell you what the right choice is or isn't.  You have to figure that out for yourself.  I can tell you how to go about it, but I can't make that decision for you.  So here's what I did.

When I was in the process of selecting a surgeon for my gender reassignment surgery, I also knew I wanted to have my breast augmentation at the same time, so that helped me narrow it to surgeons that were able to do both procedures.  The reason for this is I didn't want to go back and have to pay for anesthesia and hospital costs a second time.  Two birds, one stone.

When I first began transition, insurance was not available to me, so I had originally planned to go to Thailand and see Dr. Kamol or Dr. Preecha for my GRS and BA surgeries.

However, after I moved to Colorado in 2013, the laws here changed and insurance companies began selling trans-inclusive plans on the Colorado Exchange (Connect for Colorado) that allowed transgender individuals to have their surgeries covered.  This changed everything for me.  I no longer had to go overseas to get these procedures done.  Following this change, I began researching surgeons here in America.  My top choices were originally Dr. Christine McGinn in New Hope, PA, whom I say featured in the documentary "TRANS" and I have to be honest, I was in awe of her beauty, her personality in the documentary and I had a pre-determined mindset that she would be my surgeon. I also had selected Dr. Toby Meltzer in Scottsdale, AZ and Dr. Marci Bowers in San Francisco, CA (formerly in Trinidad, CO).  Later, I added Dr. Kathy Rumer to the list after talking with another transwoman online who told me about her.  I did my research on all 4.  I had a lot of difficulty getting hold of Dr. McGinn for a phone consult, plus she didn't take insurance at the time (this may have changed since then).  I did eventually get a phone consult with her and I was very disappointed with her phone demeanor.  Maybe she had an off day, but she seemed off, distracted and I didn't feel like what I was asking mattered or was even heard.  That's not what I needed in a surgeon.

I did a phone consult with Toby Meltzer, but I was not impressed by his phone demeanor either, not to mention his waiting list was at minimum of 2 years and I really felt more like a source of income to him than a patient who's needs were important.  Dr. Marci Bowers was much the same way and her waiting list was 3 years and I couldn't wait that long.

In January of 2015, I reached out to Dr. Kathy Rumer's office and scheduled a phone consult.  When I talked with Dr. Rumer, she was SPOT on the money about everything I asked. She was well prepared for my answers, she was friendly, courteous, open and explained everything in great detail but keeping it from getting too lengthy or technical.  During our conversation, I felt something with her that I didn't feel with the others when I spoke to them.  She felt like a familiar friend, someone I had known for a long time even though I had never even met her.  She was on the same page as me, she was tuned in to what I wanted, she listened to me, to my needs and that meant the world on me.  I had found my surgeon.  I had also done a lot of research online about her, and complaints were few, praises were high.  Everything I looked at in regards to her, I liked.  My excitement grew.  A few months later I scheduled an office consult and flew to Philadelphia in early December of 2015.  The visit went very well.  She answered all of my questions, she was so warm, caring, compassionate and friendly.  I haven't been let down by her yet and she did a great job, and as of 7 weeks post-op, I am very satisfied with my results, although there is much healing left to do.

These were the things that were important to me to have in a surgeon.  You are trusting your LIFE, your health and your future to this person.  This includes your future sex life.  The ability to have sensation, feeling, orgasms and sexual pleasure is in their hands.  You want to know that this person cares about you, your well-being, your health and your ability to enjoy the life of a woman that you have sought for so long.  You can't afford to make a mistake.

So do your research, ask questions, talk to former patients of surgeons and ask about their quality of care, personal relationship with that surgeon, aesthetic results, form and function (orgasm, sensation, ability to pee, etc).  Most of all trust YOUR instincts. Not someone else's word that refers you.  When you connect with the person that is to be your surgeon, you will know.

Choosing the wrong surgeon to save a buck or two can mean the difference in having all those things or having to go back for multiple revisions, fixing errors and mistakes, or even worse, being stuck with no sensation, no ability to orgasm, paralysis in your mons pubis region, a caved in vagina that closes up or gets a bad infection.


There are FAR too many surgeons for me to list individually on this blog, so I'll just include a convenient link to make it easier for you to find their name, location and contact information.

http://www.transhealthcare.org/usa/


Currently, there are NO surgeons in the state of Colorado that perform gender reassignment surgery for male to females or female to males. You can expect to travel out of state, have to get airfare, hotel and other accomodations, so factor this into your budget if you plan to have GRS anytime soon.


Dr. Terrance Murphy does do top surgeries for both M2F and F2M transgender people as well as FFS and other cosmetic enhancing procedures.  He is very highly regarded by the transgender community here in Colorado.

Dr. Terrance Murphy
799 E. Hampden Ave.
Suite 540
Englewood, CO 80113
Phone: 303-788-8400
info@murphyplasticsurgery.com
http://murphyplasticsurgery.com/

Recovery

My first 3 weeks home after recovery were pretty intense and difficult. They were the hardest part of the entire surgery and recovery process.

After returning home from surgery on Friday March 3rd, 2017, I had plenty of helpers coming and go, people to visit with me for emotional support, but not always exactly on the dates and times that I needed it.  Several times, I got a little sad and lonely, but I never went very long without somewhere coming by to visit or help out.

The first day home was nice.  I didn't really have anyone there, it was quiet.  My apartment complex ladies came up to visit me.  I was able to walk and get around, but very very sore.  It was unpleasant, I used my pain meds to take the edge off, I slept a lot, I ate the good food I had prepared and put in the freezer before I left (15 tupperware containers full of food).

I won't go into detail of every single day, because I don't quite remember every single one of them, but for the most part, I watched movies, I slept, I dilated 4 times a day, I showered frequently and I played on my phone.  There wasn't much else I could do.

A week after I got home, Melinda drove me to the county courthouse so I could file the motion to change my gender marker on my birth certificate.  I ran into some issues with the court clerk who tried telling me that because I changed my name in another state, that the Court didn't have any jurisdiction over my birth certificate.  Sorry, that is not the case.  I requested a manager and we got it all sorted out.  That lady had no clue what she was talking about.  The only way a Colorado Court won't have any jurisdiction to change a birth certificate is if you were NOT born in Colorado.  Name changes have nothing to do with anything.  As long as the name change was legal and you have a court certified order of the name change with you, then there is no issue as all Courts recognize official court orders from other cities and states.  That's how our Justice system works.  That lady got dressed down by the Judge for not doing her continuing education.  So I went before the Judge, and swore in and answered the questions and she signed off on it and it was done.  I went home happy that all I had left to do was get a new copy of my birth certificate.

I tried to go to the St. Patty's Day parade but a friend wasn't feeling well, so I didn't get to go.  I sat at home bored and disappointed.  I've never been to a St. Patty's Day parade or celebrated or anything.  That Monday I know I over did it completely.  The 13th I got up early, dilated, showered and then took the car downtown.  This was the first time I had driven since before my surgery.  My bottom area hurt quite a bit when I sat in the seat.  I brought a cushion that helped some, but not very much.  I got down to the Social Security office early, stood in line and was about 10 people back.  At 9 am, they opened up and I went in got my number and only waited 10 minutes.  I changed my gender marker in the system and got a receipt and then I left.  From there I opened up a safety deposit at a nearby bank and put some documents in, then left.  I drove to the Dept of Public Health building a few miles away and spent about 30 minutes in there waiting to get my new birth certificate.  It was an awesome moment when I got my new birth certificate.  I was legally a female according to the state of Colorado.  No state can ever make me use a male bathroom again.  Period. EVER.

Afterwards, I went to the grocery store, grabbed a few necessities, stopped and snagged a large french fry and a Shamrock shake from McDonald's (I usually don't eat there, but fries and shamrock shakes sounded so wonderful) and I went home.

I got home, dilated and then a visitor showed up to keep me company for awhile. Later that evening, everything went to hell in a hand basket.  I couldn't pass a bowel movement, I was backed up and it wasn't coming out.  I was constipated.  I started taking some docusate, dolculax and metamucil.  About 4:45 pm, I finally had a bowel movement after 2 1/2 days of not having one and it was the most brutal, horrifying pain I have ever felt.  A sharp, constant pain.  Being constipated and having hard stool had irritated internal hemmorhoids.  We all have them, but most of don't know we have them...until they become a major problem.  I sat on the toilet and I cried for a half hour because it hurt so bad.  My pain level was a 9.5 on a scale of 10.  Finally I drug myself back to bed, and I laid there but the pain was awful.  I was also dehydrated which didn't help matters any.  About 8:30 pm, I couldn't take it anymore and went to the hospital.  They were useless and couldn't do anything for me. Couldn't give me any painkillers since it would further irritate the issue at hand. I went home and did my best to sleep.  Got up the next morning and did some research and went to the grocery and got high fiber foods.  Blackberries, raspberries, oatmeal, peas, carrots, broccoli, wheat bread.  For a week solid I ate jello, bomb pops, soup, and the aforementioned foods, scrambled eggs and applesauce.  It was better than the alternative.  My stool was liquid for 2 weeks, but that was ok by me.  Better that, than to have that brutal pain again.  A week later I got into the doctor's office only to be told there wasn't much that could be done and that I just needed to modify my diet by adding more fiber.

Melinda and her Mom took me to celebrate the day I now recognize as my birthday (the day I legally changed my name).  We went and got Mexican food.  The doctor said I could eat whatever, just add fiber daily and drink metamucil 3 times a day.  After a week of being on a soft diet, real food was GOOD to eat.  Also had a banana cream pie for dessert at home.

The second and third week, I was sore as I can ever remember being.  I felt like someone had stretched all my muscles between my legs and drew them tight like a rubber band.  I never thought that feeling would end, but it only lasted about 14-17 days.  I was sure glad when it stopped.

Melinda took me to one of my therapist appointments and then her Mom took me the following week.

At the end of that week, I was on my own.  I was out walking, getting exercise, doing things around the apartment on my own.  I didn't need any help with much of anything.  I still didn't have all my energy, but I could drive, run errands and get around pretty good.  Melinda still checks in on me from time to time.

The soreness and hemmorhoids were the worst part, and I'm well past that now.  I've been doing little things around the apartment.  I can cook, clean, do laundry, wash dishes and what not.

I was dilating 4 times a day for the first 4 weeks and it was wearing on me a lot, but I'm now down to 3 times a day and it is so much more manageable than 4 times.  At the end of May, I'll reduce to twice a day.

I had my 6 week follow-up via Skype last Monday.  Everything is healing as it should, there are no complications or setbacks.  I do have some granulations deep in the vagina which are causing some mild burning and light pain when I dilate so I have to go see the gynecologist at the beginning of the week and have silver nitrate applied to the granulations to remove them.

I have full sensation in my clitoris (which this really excites me).  I've been granted permission by my doctor to self-explore, but not to use any sex toys or have any sexual penetration.  Exploring my new clitoris the other night was amazing.  I almost achieved my first female orgasm but not quite.  I was sooooooo close! It felt completely amazing too.  I've had some vaginal sexual sensations from dilating so there's pleasurable sensations there too.

I'm feeling much better, I have more energy and I'm able to go longer without sleeping.  However, I am trying to get as much rest as possible, exercise and have a balanced day.

I was also able to call my high school and get my transcripts updated with my legal name and I should be getting a copy in the mail in the next few weeks.  I am still working with Jostens to get my HS Diploma reprinted with my legal name as well, they just have to verify with the school.  The cost is $30.00

So that's how my recovery has been.  First 3 weeks home were the worst.  After that, it's all pretty easy sailing.  I'm enjoying the time off work, getting things done and doing some things that I want to do while I have the chance.

On April 12th, I will be approximately 7 weeks post-op.  Getting close to my time to go back to work.  I don't have to be back till the end of May, because I made sure to leave myself adequate time to recover physically and emotionally after the surgery, but I see no need to take that entire time off if I'm able to work and can do my job without pain.  So I'll probably be going back to work in early May.

So in closing, I probably won't update this post because there's not much to report with recovery.  Most of my recovery is done.  Scars have to heal, dilation will continue, but the worst is over, the hard part is behind me, the rest is day to day stuff, taking care of my body and my new vagina and breasts and enjoying being a female.

The novelty hasn't worn off.  I don't expect it will until everything's fully healed and I've gotten to enjoy it sexually a lot and explored it to it's full potential.  If it never wears off that's ok with me too. :)

Hair Removal

Hair removal is a very very expensive part of transition.  You'll probably spend more money on hair removal than any other aspect of your transition with exception to your surgeries, and in some cases even more!


https://www.bustle.com/articles/84251-6-different-types-of-hair-removal-explained-so-you-can-pick-your-best-method-for-smoothness


Hair removal is probably (read: definitely) the most annoying factor of summer. There are so many different types of hair removal, most of which are time-consuming, can be expensive, and painful. And yet, we choose to do it anyway. But if you're someone who is especially bothered by how often you have to shave, or how painful it is to wax, maybe it's time to consider the other hair-removal options. Maybe you'd prefer something a little sweeter. Maybe you'd prefer something a little more permanent.

Regardless of whether you want to alter your hair-removal style for your legs, bikini line, or underarms; depilatory creams, sugaring, laser removal, and electrolysis are all options to consider in addition to the more common shaving and waxing. Of course there are alternatives like tweezing and threading, but these generally work best for the face due to the time required and longevity they offer. So if you've ever been curious about the different types of hair removal that can be more easily used wherever you want to rid yourself of some fuzz, here's everything you need to know about shaving, depilatory cream, waxing, sugaring, laser removal, and electrolysis; and how they stack up against one another on the factors of pain, cost, and longevity.


Shaving
Most of us are probably familiar with this option, but shaving works by cutting off the hair at skin-level.

How much does it hurt? Shaving is painless as long as you are careful to not cut or nick yourself. By making sure to use a proper shaving cream or oil and sharp blades, you can decrease the chance of having razor burn or any other post-shave irritation.

How much does it cost? A razor can cost anywhere from $2 to $20 depending on what type and how many blades you prefer. And again depending on your preference, replacement blades or heads can cost anywhere from $0.02 to $5 a piece (though are usually sold in packs).

How long does it last? Because hair is only removed at skin-level, it usually grows back in one to three days.


Depilatory Creams
Depilatory creams work by dissolving the hair. They are typically smeared on in thick layers over the desired area, and left on for a few minutes before needing to be wiped off. Depilatories typically remove hair at, or slightly below, skin level. However, they are not always the most effective when it comes to coarser hair. And because of the chemicals, they can have a somewhat offensive odor.

How much does it hurt? Depilatories can have a slight tingling sensation, but are typically painless. If you are experiencing any pain (usually a burning sensation), stop and wash it off. Pain means that your skin is either too sensitive or you've left the product on too long.

How much does it cost? Depilatory creams can be purchased at drugstores for around $4 to $14.

How long does it last? Because the hair is removed, at best, slightly under skin-level, it will usually start to grow back in one to three days.

Waxing
Waxing is one of the more painful options, but because it involves removing hair from the root, it also lasts longer. This method works by applying wax to the skin, which sticks to hairs. The wax is then quickly ripped off (sometimes with a cloth strip, sometimes without), pulling the hairs out with it. The procedure is relatively quick, so even larger areas like the legs can be waxed in a trivial amount of time. However, because the wax needs to be able to stick to the hair, hair needs to be at least a quarter of an inch long before waxing. This means that hair needs to be given some time to grow out between waxes.


How much does it hurt? Waxing is like pulling off very large, very sticky bandages. Especially the first time (and depending on where you're waxing) can be painful. There are even tips about how to make it less painful. However, if you rely on waxing as a primary form of hair removal, hair will become finer over time, making the waxing experience subsequently less painful over time.

How much does it cost? To have it professionally done, waxing costs, on average, between $15 and $80 depending on the area. Waxing strips and kits can be purchased for at-home use ranging from $5 to $50.

How long does it last? After waxing, it usually takes about three to six weeks for hair to grow back.


Sugaring
Sugaring is similar to waxing. As the name implies, it involves a sugar-containing paste or gel to remove hair. It works by applying the paste or gel and, depending on the type, either removing it with or against hair growth to pull the hair out by the root. And because the medium is all-natural, you can even make it at home.

How much does it hurt? Like waxing, the hair is still being pulled out, so there will be some pain. However, because the paste doesn't stick as much to the skin itself, it is reportedly less painful than waxing.

How much does it cost? To have it professionally done, sugaring can cost anywhere from $10 to $110 depending on the area. Sugaring kits can be purchased for at-home ranging from $10 to $40, but you can also make your own at home for just a few dollars.

How long does it last? Just like waxing, it usually takes three to six weeks for hair to grow back.


Laser Hair Removal
Laser hair-removal is a long-term option that involves destroying the roots with light. This option can be permanent, but usually just reduces the amount of hair and makes it finer and lighter. It works best on those with darker hair and lighter skin, though, as the laser detects pigment. This means it will not remove white or blonde hair as effectively, and can burn darker skin. Laser hair-removal generally takes around six to 12 sessions for optimal results. And thanks to technology, there is now the option to perform laser hair-removal in the comfort of your own home.

How much does it hurt? The pain associated with laser hair-removal is often compared to a rubber band being snapped against the skin. How much this hurts will depend on your pain threshold.

How much does it cost? To have it professionally done, laser hair removal costs, on average, $200 to $900 depending on the size of the area being treated. At-home options can range from $200 to $500.

Just remember this, do NOT use IPL (Intermittent Pulse Light) for laser hair removal.  It is the least effective of all the laser hair removals.  Hair will just grow back fairly quickly and you're just throwing money away.  I used the Candela laser and it was very effective on my face.

To my knowledge, if you have blonde, grey or red hairs the laser can not pick them up and can't zap them.  So you most likely would have to do electrolysis if you wanted hair removal.  

Deals

Sites like LivingSocial.com and Groupon.com always run specials and deals on services.  You can also search for makeup, hair stylists, electrolysis, clothes and more.  Shop smart and save big!  Look for coupons, watch facebook and twitter for specials.

Mile High Laser and Aesthetics is currently offering full body laser hair removal for $500.  This deal is INSANELY good!

https://www.livingsocial.com/browse/cities/26/searches?utf8=%E2%9C%93&city_search_id=26&country_search_id=1&query=laser+hair+removal&city_name=Denver


https://www.groupon.com/browse/denver?locality=Denver&administrative_area=CO&lat=39.73915&lng=-104.9847&address=Denver%2C+CO&query=laser+hair+removal&hasLocCookie=true&locale=en_US

Education & Employment

Many transgender individuals are low income, living at or near poverty levels, job opportunities are far and few between and face many many socio-economical hardships that can be difficult if not impossible to overcome.  Additionally, a lack of knowledge of their resources around them contributes to this situation.  This blog post aims to change that.  I want to give you those resources. I want to help you better yourself, believe in yourself so that you can succeed as I have done.

Education is the single most important thing that can aid a transgender person in their transition, getting hormones, therapy and their surgeries.  Quality education leads to job opportunities, which leads to self-sustaining income.  When you have self-sustaining income, you can afford to pay for the things you need regarding your transition.  But there are no quick fixes. It's a process that takes time, dedication and perseverance.

You can make excuses, cry, pout, be depressed and feel sorry for yourself, or you can pick yourself up, make a choice and say I'm going to do this, I'm going to succeed, I'm going to be someone.  The more you tell yourself this, the more you will believe it and then you will do it.

I am a transgender woman and I have a high school education, I also have a bachelor's degree in Digital Media Communication, but my degree didn't land me a job.  I ended up going to a truck driving school and I got my Class A CDL and currently I drive for a living.

So the moral of this story here is, just because you go to college and get a degree field doesn't mean you will automatically get a job.  However, there's a lot that goes into my situation.  I live in the Denver metro area.  The demand for jobs in my career field is very limited due to geography (i.e. Colorado and Denver). There are jobs, but many of them are a matter of knowing the right people, which I do not.  I am also NOT willing to relocate.  I could go to Dallas, Houston, Miami, NYC, Los Angeles, Phoenix, Seattle, Kansas City, wherever pretty much and I could more than likely get gainful employment in my degree field with a reasonable salary to start.  But living anywhere else outside of Colorado is NOT an option for me.  This is where I WANT to be.  This is where I believe I NEED to be.  I probably didn't choose the best career field to get my degree in.  It's very broad and has no real specialty to it.  I found this out the hard way.  I won't minimize my accomplishments, but I definitely could have chosen a little wiser.

As such, when things don't go how you want, you MUST adapt.  You have to be willing to do something else when what you want isn't available.  I could have taken a graphics design job, but my heart wasn't in it.  So for the first 7 months here, I unloaded trailers at night, I cleaned offices on 2nd shift and I worked Broncos games on game days. I scratched, I clawed and I fought for everything that I wanted and I had some help doing it.  Then I found out about driving a truck from a guy who was making $1300 a week, so I inquired with him what I needed to do and he said go to truck driving school, so that's what I did.  I went to a truck driving school, I passed my CDL test, then I got hired on with a company, did 7 weeks of training with a qualified expert trainer and was given my own truck.  I worked for that company for a year and got my experience then I moved on to a company that paid much better and I've been there for 2 years and now I'm making that $1,300 a week.

You have to believe in yourself, you have to be willing to fight for what you want, you have to put in that effort and you have to reach out and TAKE what is rightfully yours because NO ONE is going to give it you.


High School Equivalency Testing

If you did not graduate high school, now is a good time to get that diploma by going through the state's graduation equivalency testing program.  With a GED you open up the door to college, basic jobs, technical schools, certification programs as most if not all of these at minimum require a GED or HS Diploma.  

https://www.cde.state.co.us/postsecondary/hse

This is the first step, and while it may not yield the results you want, we all have to start somewhere.  Just remember when you first started transition.  It wasn't perfect, but it was a start.  Many LGBT centers also have people who are available to assist you with this or find tutors willing to volunteer to help you study.


Community College vs a 4 Year University
Deciding between a community college and a 4-year University can be a difficult decision for some.  However for most it comes down to grades and finances.  If you struggled in high school and/or you don't have money to go to the school you want, then you may have to start at a community college.  There's nothing wrong with this.  I attended a community college for 1 semester and got 15 credits before transferring to a 4-year University.  I wish I had done all of my general education requirements at the community college.  Classes are less expensive, tuition is more affordable and the classes are easier, smaller in enrollment size and your professor can work with you one on one and help when you struggle better than a professor at a 4-year university can.

Here's a very in depth article on the subject.

Always remember to do the research and weigh the pro's vs. cons and talk to those around you in your family or support system and ask for guidance, thoughts, suggestions and make the best decision for yourself.


Vocational Training vs. a College Degree
Not everyone is cut out to go to college.  Not everyone wants to go to college.  Some people want to go to a Vocational School, take classes specific to a trade or skillset, and then get the rest of their education with on-the-job training.  A vocational school affords a person that ability. There have been many millionaires that never got a college degree, but instead went to a Vocational School.

http://mycollegeguide.org/blog/2016/08/trade-school-vs-college/

http://www.thesimpledollar.com/why-you-should-consider-trade-school-instead-of-college/

However, be wary of vocational schools that are just after your money. Many don't provide adequate job training or valid certifications, so check with the Better Business Bureaus and if you need a quality recommendation for a trade or vocational school, then I suggest researching some companies that employ the trade you wish to get into and either call or go talk to some of the hiring managers there and ask them what vocational schools they are hiring from.  Most if not all will have a good recommendation for you.

There are many unions around Colorado and Denver that offer apprenticeships which include on the job training as well as in the classrooms.

Here's a link of Unions in Colorado and their contact information

Here is another link as well
http://labor-unions.findthecompany.com/d/b/Colorado


There is currently a construction on the job training project hiring and training now!
https://www.buildcolorado.com/

• Carpentry
• Concrete Finishing
• Construction Technician
• Drywall & Finishes
• Electrician
• Enclosures
• Glazier
• Heavy Equipment Operator
• HVAC Installer/Technician
• Ironworker
• Mason (Brick, Block, Stone)
• Painter
• Pipefitter
• Pipelayer
• Plumber
• Sheet Metal Worker
• Tile Setter
• Welder

Workforce Investment Act
There's a myriad of resources available to everyone in the workforce.  Colorado offers one called WIA or the Workforce Investment Act.  They pay up to $5,000 for training.  Preference is given to veterans, but it is NOT a requirement to be a veteran to get it, you just get to go to the front of the line if you are a military veteran.  WIA provides resources for those struggling to find work, those who don't have quality job training, lack skills or are in need of a new career field.

https://www.colorado.gov/pacific/cdle/wia-js

We are here to help you prepare for employment, find and keep a job, and increase your earnings through a federally-funded program called the Workforce Investment Act (WIA)
For example, through this program, we offer employment services including:

• Assistance with job leads and labor market information

• Resume assistance and critiques

• Education and career assessments

• Employment readiness and job search workshops

• Career counseling and career planning

• Supportive services

• Intensive job search assistance

Additionally, we offer limited training assistance for short-term training programs that lead directly to jobs identified as “in demand” in the local labor market. Training programs can take the form of classroom training, on-the-job training, internships, or apprenticeships.

To find out more, apply at your local workforce center and read the eligibility and qualifying criteria below.

Commercial Truck Driving
If all else fails, you can always drive a truck.  You can go to a truck driving school, take the classes, take the test and when you pass, you can get your Class A or Class B CDL and you can drive a commercial motor vehicle (CMV).  First year drivers can expect to make between $32,000 and $45,000 their first year.  After your first year or two, you can go get a better job and make about $60,000 - $100,000 a year after that depending on where you go and what kind of trucking that you get into.  It's a good way to make a living and it will most definitely help you with your transition expenses, getting health insurance, paying for surgeries and procedures.  It can be a long-term thing or you can just do it to get through your transition and then move on to something else.

The class consists of a 160 hours of training.  There's a few schools in Denver and in Colorado that provide this training.  All offer financing.  If your credit isn't good, usually you can put a couple $100 down and they will finance you anyways, but some may require a co-signer to get the financing.  WIA will cover up to $5000 of your truck driving training.  You might also be able to apply for FAFSA (Financial Aid).

If you can't find financing, then there are a few trucking companies that will put you through company paid training and truck driving school however, you MUST sign a contract with them for 2 years and work there. Do this as a LAST resort.  If you quit or get fired, you're on the hook for that money and they usually want it the day you end your employment.  Some of these companies are completely shady.  I'll get into that here in a minute.

Truck Driving Schools in Colorado

US Truck Driving School has two schools.  One in Wheat Ridge, CO and one in Fountain, CO.
https://ustruck.com/

Sage Truck Driving School has multiple schools in the state of Colorado
http://www.sageschools.com/


Here's a list of other truck driving schools in the state

http://www.truckingtruth.com/schools/colorado-truck-driving-schools


If you absolutely MUST get company provided training, then do so.  I'd recommend Knight Transportation to start with as your top choice.  

http://www.driveknight.com/transportation-driver-training/

Swift, Werner Enterprises and CR England should all be your FINAL/LAST RESORT options. These are what are called megas (Mega Trucking Companies).  They have deep pockets, treat their drivers poorly (I worked for Werner and I did my year and I left as soon as possible) they pay poorly and generally drivers there are not very happy.  But we all have to start somewhere, so if you have to do the dirty then suck it up, do your year, don't have any accidents and then find a better paying job and move on.

Companies to get your CDL training and your start with:

• Celadon
• Knight Transportation
• Prime
• Roehl
• Millis Transfer
• Schneider
• Stevens Transport
• Werner
• Swift
• CR England

Types of Trucking

Currently I run Linehaul.  All linehaul consists of is going from one destination to a meet point or other terminal, swapping with another driver and then you come right back.  I've done Flatbed, Over the Road and Linehaul to date.  I like and prefer Linehaul the best.  I come home to my bed every night, I work five days on, and I have my Sundays and Mondays off and I make about $60,000+ a year.  My schedule is set and I work a day route and I go to the same place five days a week and I come right back.  Sleep in my own bed and I have a nice, consistent routine which allows for stability in my life.  

There's many types of trucking though.  Sometimes you have to find your niche, so try several types until you find what works for you.  

• Linehaul/LTL (Less than Truck Load)
• Tanker
• Over the Road (53' trailer, 48' trailer)
• Intermodal (Usually running from terminal to railyards and shipyards)
• Heavy Haul (Hauling houses, and over-sized loads, requires a lot of experience)
• Oilfield
• Reefer (Refrigerated)
• Dump Truck
• Car Hauler/Auto Carrier
• Expediter and Hot Shot Trucking
• Local/P&D (Pickup and Delivery)  - Usually a lot of city driving.

The best way to start is get on with a company doing a regional or local dedicated account where you have the same stops every day.  It's usually the same paycheck every week, same schedule and weekends off.  Doing this allows you to get familiar and comfortable with the truck, with backing, and all the other things that come with trucking.  

Advanced Secondary Education

For those of you that are ambitious go-getters and your Bachelor's Degree isn't enough, you can opt to go get your Master's Degree, your PhD. or youmaychoose to go Law School and get your Jurisprudence Degree.

In closing you have a lot of options and of those, at least one can suit your needs.  You don't have to be rich, you don't have to have a $100,000 a year job, or drive fancy cars, but find something you can do, that you enjoy doing and make a career out of it.  I say this from personal experience, once you have your surgery, nothing else really matters.  I could take a job making $10 an hour tomorrow and I'd be completely happy because my surgery is already done and I'm finally at peace with myself.