Depending on the effect of the hormones, the patient may choose to have a breast augmentation if their breast development is not sufficient. During this phase, it is also important to expand the penile skin by stretching. Any extra skin from the scrotum is trimmed to create the labia lips of the vagina.
The urethra is then shortened to the appropriate length and stitched to its new position in the skin. Once the operation has been done, the patient stays in hospital for five days until the catheter can be removed. They then come to the outpatients to check that everything settles down adequately.
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Tom was allowing his once very short, mostly grey hair to grow out. It looked terrible, but of course that was beside the point.
He brought home a hairbrush and kept it in the bathroom closet. One day, he walked into the bathroom while I was combing my hair.
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He positioned himself next to me before the mirror and began to brush his own hair. When he was done, he smirked knowingly at his reflection and, tracing an exaggerated arc with his hand, very deliberately dropped his brush into a basket I kept for my things beside the sink.
Such moments packed a breathtaking array of meaning and emotion. All at once there was the pathos of witnessing a middle-aged man - the husband I loved and had admired - taking pleasure in gazing at the woman he evidently saw when he looked at himself in the mirror. His satisfaction with himself. His in-my-face "I'm going to do this and you have no choice but to accept it" attitude towards me.
The painful fact that such moments represented his departure from our marriage and from the person he had been, and that I was forced to watch that departure not once but over and over again. The terrible feeling of intrusion into my space, my privacy.
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Like a rebellious teenager, he wanted me to know: you aren't the only woman around here any more. He wanted me to know: absolutely nothing will be left to you. My basket had become a public receptacle marked All Women's Things Go Here.
Like womanhood itself, it was no longer my domain. Tom found a circle of women to sympathise with, encourage and dress him.
Once, he left his laptop open to a message from one of them that read, "Your wife has to accept losing you. From his cheerleaders I learned that in the new political correctness, female solidarity is out. A man in a dress is in. Among women who consider themselves feminists, a man who declares himself a transsexual trumps another woman any day. One of Tom's supporters would eventually sum up this perspective most explicitly: "He's a transsexual.
Anything he does is what he needs to do. These career women told Tom, and some would later tell me, that my wifely role was to support my man and to get my children on board with the project. My responsibility was to Tom.
Tom's responsibility was to Tom. In the Valley of the Politically Correct, being a transsexual means never having to say you're sorry. Tom shaved off the beard he had been wearing since I met him at He shaved off the chest hair I had loved to run my fingers through.
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One day he came home with his eyebrows plucked to within an inch of their lives, a style choice I tried unsuccessfully to convince him no actual woman had made since the s. In our joint account I saw payments to a voice coach. I discovered that he carried a portable tape recorder with him during solo drives, so that he could work on raising his pitch.
I found this out when he let our toddler play with the tape recorder, a button was hit, and out of the machine came a weird, feminised lisp that neither the children nor I had ever heard before: Daddy's new voice. Did the kids notice Tom's transformation? They didn't say and I didn't dare ask.
Neither the kids nor I would actually see him dressed as a woman during the two years his transformation took place under our roof, or for many months after. We didn't have to confront him modelling the new threads, but I, for one, couldn't forget that they were there.
Knickers that weren't mine were now regulars in our laundry. I also caught glimpses of their lace edges peeking out of his jeans when he bent over to help one of the children, and a bra was sometimes visible underneath his man's shirt.
He said it made him feel better. Presumably the falsies I found around the house also made him feel better.
The only problem was, they made me feel worse. I felt like a woman encountering the presence of an intruder in her marriage in the traces of infidelity among her husband's things.
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Only the lipstick smears weren't on my husband. They were my husband's. Again and again Tom promised he would do nothing further; again and again he broke this promise. To my anguished and outraged, "But you said " he'd tell me, sometimes in anger, sometimes icily cold, "That was yesterday. I didn't say anything about today. When people ask how I continued to live so long with a man who was no longer my husband, the truest answer I can give is, for my children. Day by day I begged Tom to grant our children a little more childhood.
For more than a year and a half, I put off telling them.
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As anyone who knows kids will guess, this ultimately proved a losing strategy, as their growing awareness that their father was changing and that something had gone terribly awry in their parents' marriage erupted in confusion, fear and stress. I took it for granted that if Tom was really going to live as a woman, he would move away, or the children and I would move away.
It went without saying that I wasn't going to attempt a fresh start in the small town in which we had lived together as a happy family, passing Tom on the street in a dress. When I put this to Tom, he erupted. I'm not leaving this house. I'm going to do what I want to do and I'm going to do it right here.
They belong to me.
If you want to leave, go right ahead. But you're not taking the kids with you.
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This was the emergence of the new Tom, one I'd come to know very well over the next several years. The one who intimidated and threatened, who laid down the law and expected me to abide by it. If Tom was becoming a woman, he had never seemed so male - a tyrannical bully he had never been in our marriage. Many conversations followed from that one, and in this respect Tom remained consistent.
The new life, the choices and decisions, were his. The children and I would live with whatever he decided. Around our town Tom began to wear gender-neutral clothes, which in actual fact meant female but not overtly feminine: women's jeans, a blouse kept zipped inside a navy blue sweatshirt.
He went about looking pale and dreadful, and speaking in an exceedingly odd, high-pitched whisper, and so some people concluded that he was ill. I wanted desperately to contain the truth for my sake and my children's.
By continuing to live with him, I could at least forestall the day he would appear in full female regalia in front of the children or in our community, because Tom had grudgingly come to realise that, for the time being, forcing me or the children to see him, as he put it, "dressed" would not be wise. Again, my delays were a losing strategy. Tom was not trying out a possible lifestyle. He was making permanent changes. By the end of the first year, his most valuable beauty tool was a daily dose of female hormones.
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It is inescapable: for me there is something slightly creepy and more than slightly sad about a man in women's clothes. Male legs in sheer stockings.
The sight of Tom in an exact replica of a skirt that was once my favourite. It is creepy for one woman to copycat another, the stuff of thrillers.
Creepier for a man to do the same. Creepier still if that man is your husband. Looking back, I can say Tom was a wonderful husband, father, friend.
Or I can say Tom was a fabrication. A fake, who didn't want to be with me, he wanted to be me. When he moved out, all I was left with was his male wardrobe: a collection of trousers, shirts, jackets and ties. Clothes I had loved and, in some cases, given him. It was as if he had left the bedroom expecting to come back. As if he had suddenly died. It was a Tom reborn who loaded up his car and said goodbye to his children. This Tom was upbeat and energetic, eager to set off on his new life adventure.
He had rented a room in a house in another town, and he would visit the children several afternoons a week. The children ran manically in and out of the house, confused. Their father moving out was a bad thing, right? But he looked so happy!
Tom and I have since divorced. I want to say the kids are all right now. The truth is, some days they are. Some days one or two of them are. Children look to adults to stay the same. Mine have watched their father change his personality, his appearance, his lifestyle, his address and his name. Their experience of Tom's transformation and the break-up of our marriage is hands down the ugliest and most painful ct of this story.
Recently, out walking, I passed a young family: a mother and a father with a baby in a pack on his back. Watching them together, I was rushed by memories. Tom and me with one, then two, then three small children, babies in backpacks. My God, we were happy!
That's what hit me. In recent years I've absorbed Tom's revisions, come to believe I was delusional to think for so long that we were happy.
I was not delusional.
We were happy. We had a long time together. Now that time is over.
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We were married and now we're not.